TMPPM 2010 > Volume 1, General Information > Section 6: Claims Filing > Claims Filing Instructions > Claim Form Requirements > Clients with a Designated or Primary Care Provider

   
 

6.4.1.7 Clients with a Designated or Primary Care Provider

Claims for clients with a primary care provider or designated provider (i.e., managed care clients or Limited Program clients) must indicate the primary care provider or designated provider identifiers in the billing or performing provider fields.

When clients receive services from a different provider, such as a specialist, the primary care provider or designated provider's information must be included in the referring provider fields on the claim.


Texas Medicaid & Healthcare Partnership
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