TMPPM 2010 > Volume 1, General Information > Section 6: Claims Filing > Claims for Medicaid Hospice Clients Not Related to the Terminal Illness

   
 

6.16 Claims for Medicaid Hospice Clients Not Related to the Terminal Illness

When the services are unrelated to the terminal illness, providers must submit a claim for Medicaid services to TMHP. The claim must include a statement and documentation from the hospice that the services billed are not related to the client's terminal illness.

If TMHP denies the claim, providers must send an appeal with the following information:

A copy of the R&S Report, with the client or claim number in question circled

Clinical records, which may be obtained from the hospice provider

Supporting documentation giving reasons the services billed are not related to the terminal illness


Texas Medicaid & Healthcare Partnership
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