TMPPM 2010 > Volume 1, General Information > Section 6: Claims Filing > Claims Information > Claims Filing Deadlines > Claims with Incomplete Information and Zero Paid Claims

   
 

6.1.3.4 Claims with Incomplete Information and Zero Paid Claims

Claims listed on the R&S Report with $0 allowed and $0 paid may be resubmitted as electronic appeals. Previously, these claims were only accepted as paper claims and were not accepted as electronic appeals. Appeals may be submitted through a third-party biller or through TexMedConnect.

Zero-paid claims that are still within the 95-day filing deadline should be submitted as new day claims, which process faster than appeals. Claims can be resubmitted past the 95-day deadline as new day claims if the following fields have not changed:

Provider identifiers

Client Medicaid number

Dates of service

Total billed amount

All other appeal guidelines remain unchanged.


Texas Medicaid & Healthcare Partnership
CPT only copyright 2009 American Medical Association. All rights reserved.
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