Index
A -
B -
C -
D -
E -
F -
G -
H -
I -
J -
L -
M -
N -
O -
P -
Q -
R -
S -
T -
U -
V -
W -
X
A
AAPD periodicity guidelines
Abatacept (Orencia)
Abnormal hearing screening results
Abortion 1 2
Abuse
child abuse
DFPS Abuse Hotline
reporting
staff training
Abuse and fraud
policy
Accessories, durable medical equipment (DME) (home health)
Accident
related claims
resources and refunds
Accident resources, refunds
ACD systems
accessories
documentation requirements
items not covered
prior authorization
replacement
Acknowledgement statement
prior authorization
Acronym dictionary
Add date for client eligibility
Addiction
see Chemical dependency
Addresses
Appeals
Paper
Cost report
Medicaid Audit
CPT coding manual
DARS, blind services
DSHS offices
HHSC
commissioner
complaints
Complaints
DSHS-BHO services 1 2 3
HMO services
fee-for-service and PCCM
exception requests
Limited Program
Medical and UR Appeals
provider complaints
utilization review (UR)
HHSC offices
eligibility services
OIG
regional offices
Presumptive Eligibility Program
Provider Enrollment
public health districts
refunds
Texas Medical Board registration department 1 2
TMHP
Inquiry Control Unit
Adjustments
Adolescent
cervical cancer
communicable disease reporting
hematocrit
hemoglobin
hyperlipidemia, screening for
Adoption agencies
Advance directives
Advanced practice registered nurse (APRN)
benefits and limitations
claims filing
resources
enrollment
Aerosol treatment 1 2 3
Allergy immunotherapy
Allergy injections
Allergy services
Alveoloplasty
Ambulance 1 2
benefits and limitations
claims coding
origin and destination codes
place of service codes
claims filing
appeals
claim form examples 1 2 3
disposable supplies
resources
disposable supplies
emergency
enrollment
extra attendant
Medicaid disposition
Medicare disposition
nonemergency
prior authorization 1 2
oxygen
prior authorization 1 2 3
nonemergency
retroactive eligibility
types, definitions 1 2
reimbursement 1 2
disposable supplies
night call
subscription plans
transports
air or specialized vehicle 1 2
emergency 1 2
out-of-state prior authorization
hospital
multiple client
no transport
nonemergency 1 2
not medically necessary
nursing facility
pregnancies
specialty care
to or from state institutions
types of transport
waiting time
Ambulatory blood pressure monitoring
Ambulatory electroencephalogram (A/EEG)
Ambulatory surgical center (ASC)
benefits and limitations
claim form example (hospital-based)
claims filing
claim form example
claim form example (hospital-based)
claims resources
cochlear implants
colorectal cancer screening
dental services
documentation requirements
enrollment
fluocinolone acetonide
global services
implantable infusion pump
prior authorization
reimbursement 1 2 3
surgery
incomplete procedures
American Society of Anesthesiologists (ASA)
physical status descriptions
Amifostine
Anesthesia
administered by surgeon
claims filing
claim form example
complicated
CRNA
dental 1 2
for labor and delivery
modifiers
multiple procedures 1 2
pain management
physician services
provided by the surgeon
reimbursement
medical direction
monitored anesthesia care
prior authorization requirements
reimbursement methodology
Antibiotics and steroids
Antihemophilic factor
Appeals
AIS
allowed AIS appeals
claim corrections
client eligibility
Guide
deadlines
electronic submission
advantages
disallowed electronic appeals
HHSC
Provider complaint
paper
fee-for-service
other insurance denial
Paper
utilization review (UR)
medical necessity denial
submitted incorrectly
Audiological aervices
reimbursement, hearing aid and audiological services
Audiological services
enrollment
Audiology
noncovered services
School Health and Related Services (SHARS)
Audiology evaluation and diagnostic services
Audiometry evaluation and diagnostic services
Auditory brainstem implant (ABI)
Authorization for Use and Release of Health Information
English
Spanish
Authorization requirements
corneal topography, optometric services for
CT, CTA, MRI, and MRA
electrodiagnostic (EDX) testing
Authorization to Release Confidential Information
Automated Inquiry System
B
Bacillus Calmette-Guérin (BCG)
for treatment of bladder cancer
Bariatric surgery
prior authorization requirements
Bathroom equipment
bath shower chair tub transfer bench
documentation requirements
hand-held shower wand
payable procedure codes
prior authorization
Batteries
battery charger
wheelchair
Behavioral health
Blind Children's Vocational Discovery and Development Program
claim form example
claims information
documentation requirements
enrollment
Medicaid Managed Care enrollment
reimbursement
Case Management for Children and Pregnant Women (CPW)
assistance with claims concerns
assistance with program concerns
benefits, limitations, and prior authorization
claim form example
claims information
documentation requirements
eligibility
enrollment
Medicaid Managed Care enrollment
prior authorization
referral process
reimbursement
technical assistance
court-ordered and DFPS-directed serivces
Early Childhood Intervention (ECI)
benefits, limitations, and prior authorization
case management services
claim form example
documentation requirements
ECI referral requirement
enrollment
Medicaid Managed Care enrollment
reimbursement
electroconvulsive therapy (ECT)
family therapy/counseling services
forms
see Forms
inpatient
hospital psychiatric services
consultations
discharge
documentation
prior authorization
psychological and neuropsychological testing services
reimbursement
licensed clinical social worker (LCSW)
benefits, limitations, and prior authorization
claim form example
documentation requirements
enrollment
prior authorization
court-ordered and DFPS-directed services
more than 30-encounters per year
subsequent prior authorization requests
reimbursement
licensed marriage and family therapist (LMFT)
benefits, limitations, and prior authorization
documentation requirements
enrollment
prior authorization
court-ordered and DFPS-directed services
more than 30-encounters per year
subsequent prior authorization requests
reimbursement
licensed professional counselor (LPC)
benefits, limitations, and prior authorization
claim form example
documentation requirements
enrollment
prior authorization
court-ordered and DFPS-directed services
more than 30-encounters per year
subsequent prior authorization requests
reimbursement
licensed psychological associate (LPA)
benefits, limitations, and prior authorization
12-hour system limitation
formula applied
procedure codes to which it applies
retrospective review
enrollment
managed care
mental health (MH) mental retardation (MR)
benefits, limitations, and prior authorization
billing units
claims filing
documentation requirements
enrollment
Medicaid Managed Care enrollment
mental health rehabilitation
rehabilitative services limitations
reimbursement
service coordination contact codes
mental health case management
claim form example
narcosynthesis
non-covered services
outpatient services
annual encounter/visit limitations
prior authorziation after limitations met
pharmacological regimen oversight and pharmacological management services
documentation requirements
indications for
prior authorization
reimbursement
physician
benefits, limitations, and prior authorization
12-hour system limitation
formula applied
procedure codes to which it applies
retrospective review
enrollment
psychiatric diagnostic interviews
documentation requirements 1 2
domains of a clinical evaluation
prior authorization 1 2
reimbursement 1 2
psychological and neuropsychological testing
psychologist
benefits, limitations, and prior authorization
12-hour system limitation
formula applied
procedure codes to which it applies
retrospective review
claim form example
enrollment
psychotherapy/counseling
documentation requirements
initial outpatient
insight oriented behavior modification
prior authorization
subsequent outpatient
supportive outpatient
screening, brief intervention, and referral to treatment (SBIRT)
brief intervention
brief treatment
claims filing
documentation requirements
referral to treatment
reimbursement and limitations
screening
Benefit and taxonomy codes
Benefit code
claims filing
prior authorization
Benefits and limitations
ambulatory surgical center (ASC)
federally qualified health center (FQHC)
home health services (DME)
hospital ambulatory surgical center (HASC)
portable X-ray supplier
radiological and physiological laboratory
renal dialysis facility
rural health clinic (RHC)
tuberculosis clinic
Benefits for Medicare/Medicaid Clients
Bilevel positive airway pressure system
BiPAP S
prior authorization
BiPAP ST
prior authorization
with backup (such as BiPAP ST)
without backup (such as BiPAP S)
Billing clients
Biologicals
reimbursement
Blepharoplasty procedures
Blind Children's Vocational Discovery and Development Program
reimbursement
Blood counts
Blood glucose monitors (DME)
prior authorization
Blood pressure devices 1 2
prior authorization
Blood tests
hemoglobin type
lead screening
Blood transfusions
Bone marrow aspiration
Bone-anchored hearing aid (BAHA)
Botulinum toxin type A
Brachytherapy, radiation therapy
Brain imaging
benefits and limitations
BRCA Testing
Breast cancer screening
BRCA testing
mammography
prognostic breast cancer studies
Breast imaging studies
Breast pumps
Breast reconstruction
Breat pumps
prior authorization
C
Cancer
bladder cancer, Bacillus Calmette-Guérin (BCG) for treatment
breast cancer screening
BRCA testing
mammography
chemotherapy
colorectal cancer screening
colonoscopies
average risk
high risk
sigmoidoscopies
hereditary nonpolyposis colorectal cancer (HNPCC)
Prognostic breast and gynecological cancer studies
Cancer screening and testing
physician services
Canes, crutches, walkers
Cardiac blood pool imaging 1 2 3 4
Cardiopulmonary resuscitaiton (CPR)
Case Management for Children and Pregnant Women (CPW)
reimbursement
Catheters, impantation
CCP
see Comprehensive Care Program
Centers for Medicare & Medicaid Services (CMS)
codes
Certificate of Authority
Certificate of Filing/Certificate of Incorporation
Certificate of Formation
Certificate of Good Standing
Certificate of Incorporation
Certification Statement
prior authorizations
Certified nurse-midwife (CNM)
benefits and limitations
deliveries
newborn services
antepartum and postpartum
birthing center
hearing screening
prior authorization
claim form example
Documentation requirements
enrollment
reimbursement 1 2
Certified registered nurse anesthetist (CRNA)
benefits and limitations
claims filing 1 2
claim form example
enrollment 1 2
epidurals, blood patch
interpreting the R&S report
reimbursement 1 2
Certified respiratory care practitioner (CRCP)
benefits and limitations
claims filing
claim form example
Claims filing
documentation requirements
enrollment
prior authorization
procedure codes
reimbursement 1 2 3
Cervical cancer screening
CHAMPUS
change of address telephone number
Checklist for HHSC Monitoring
Chelating agents
deferoxamine mesylate (Desferal)
dimercaprol
edetate calcium disodium
edetate disodium
Chemical dependency
behavioral health services
claim filing
reimbursement 1 2
Chemical dependency treatment facility (CDTF)
benefits, limitations, and prior authorization
claims filing 1 2
documentation requirements
enrollment
outpatient counseling
prior authorization
reimbursement
Chemistry tests
Chemotherapy
administration
procedure codes
Chest physiotherapy devices
Chest X-rays
Child Abuse Reporting Guidelines 1 2
Children with Special Health Care Needs (CSHCN) Services Program
TPR
Children's hospitals
CHIP benefits
CHIP perinatal program 1 2
claims 1 2
newborn transfer
client eligibility verification
program benefits
Chiropractic services
benefits and limitations
claims filing
claim form example
enrollment
reimbursement 1 2
Chlamydia
Circumcisions
Claim Status Inquiry Form
Claims filing 1 2 3 4
addresses
ambulance
ambulatory surgical center (ASC) 1 2
appeal time limits
banner message R&S example
batch numbers
CHIP perinatal
CHIP perinatal newborn transfer
claim form example
office visit with lab and radiology
claim form examples
Ambulatory surgical center (ASC)
Chemical dependency treatment facility (CDTF)
Comprehensive Outpatient Rehabilitation Facility (CORF) (CCP Only)
Diagnosis and Treatment (Referral from THSteps Checkup)
Durable Medical Equipment (CCP Only)
Early Childhood Intervention (CCP Only)
Family Planning Services for Hospitals, FQHCs
FQHC Encounter (T1015)
FQHC Follow-Up
Hospital Outpatient
Hospital-Based ASC
Independent Laboratory
Inpatient Psyciatric Hospital/Facility (CCP Only)
Inpatient Rehabilitation Hospital (CCP Only)
medical nutritional counseling (CCP only)
Orthotic and Prosthetic Serives (CCP Only)
Physical Therapists (CCP Only)
Private Duty Nurses (CCP Only)
Radiation Therapy
Radiological/Physiological Laboratory and Portable X-Ray Supplier
Renal Dialysis CMS-1500 Example
Renal Dialysis Facility CAPD Training
Renal Dialysis Facility CAPD/CCPD
Rural Health Clinic Freestanding
Rural Health Clinic Freestanding (Immunization
Rural Health Clinic Hospital-Based
School Health and Related Services (SHARS)
Speech-Language Pathologists (CCP Only)
THSteps Established Patient and Referral, TB Skin Test, and Physical Examination by a Physician
THSteps New Patient/Immunization, Physical Examination by a Nurse Practitioner, and FQHC Billing (medical checkup)
Tuberculosis
claims filing instructions
coding
benefit code
diagnosis coding
modifiers
procedure coding
rate hearings
type of service
Crossover Type 30 claim form (MRAN)
Crossover Type 31 and 50 claim form
deadline exceptions
deadlines
2010 calendar
2011 calendar
appeal time limits
exceptions to the 95-day filing deadline
incomplete information
reminders
zero paid claims
electronic billing
forms
gaining access
provider check amounts
training
electronic claim acceptance
electronic rejections
newborn claim hints
electronic submission
federally qualified health center (FQHC) 1 2
filing a Medicare-adjusted claim
filing a Medicare-denied claim
genetics
hearing aid and audiological services
HHSC payment deadline
home health services 1 2
hospice clients
medical services
lab and X-ray
hospital ambulatory surgical center (HASC) 1 2
independent laboratory
instructions
attachments to claims
claim form requirements
clients with a designated or primary care provider
CMS-1500
CMS-1500 claim form (blank)
CMS-1500 claim form (paper) billing
CMS-1500 electronic billing
CMS-1500 instruction table
Crossover Type 30 (MRAN)
Crossover Type 31 and 50
dental claim form
instruction table
dental filing instructions
claim form (paper) billing
electronic billing
Family Planning 2017 Claim Form (blank)
Family Planning 2017 Claim Form instruction table
group providers
multipage claim forms
newborn clients without Medicaid numbers
patient status codes
filing tips for outpatient claims
prior authorization numbers on claims
provider signature on claims
UB-04 CMS-1450
claim form (blank)
claim form (paper) billing
electronic billing
instruction table
occurrence codes
vision claim form
Julian dates
managed care 1 2
medical services
lab and X-ray
Medically Needy Program (MNP)
Medicare
Medicare primary paper
Medicare/Medicaid deadlines
modifier requirements for TOS assignment
anesthesia
assistant surgery
interpretations
technical components
modifiers
NDC
other insurance filing
110-day rule
claims forward to other insurance carriers
credits
deadlines
deductibiles
HMO copayments
verbal denial
paper claims
portable X-ray supplier
Preferred Provider Organization
processing procedures
fiscal agent
payment error rate measurement (PERM)
R&S Reports
banner pages
radiological and physiological laboratory
Remittance and Status (R&S) Report
delivery options
examples
account receivables
adjustments
appendix
backup withholding penalty information
banner page
claims in process
IRS levy
manual payouts
paid or denied claims (hospital)
paid or denied claims (physician)
refunds for Managed Care
refunds for Medicaid
reissues
sub-owner recoupments
summary
system payouts
void and stop pay
field explanation
section explanation
status of claims
renal dialysis facility 1 2
resubmission of TMHP EDI rejections
rural health clinic (RHC)
specialist services
STAR Health Program
STAR+PLUS
tips
tuberculosis clinic 1 2
vision services
Claims filing and reimbursement 1 2 3
Claims Filing for OT Services
Claims Filing for PT Services
Claims filing information
managed care
Claims filing instructions
abortion
ambulance transfers
dental claim form
instruction table
home health services 1 2
Hysterectomy Acknowledgment Statement
paper claim
sterilization
THSteps Dental
Claims Resources 1 2
Vision Services
Client billing 1 2
Client eligibility
add date
CHIP perinatal program
deceased individuals
expedited
foster care
limited
duration
emergency
exceptions 1 2
hospital services
Medicaid identification
referrals
restricted Medicaid coverage
selection of provider/pharmacy
long term care
managed care
Medicaid Buy-In Program
Medicaid eligibility verification
Medicaid for breast and cervical cancer
Medicare Part B Crossovers
Medicare/Medicaid
clients without QMB, MQMB status
contract with outside parties
QMB/MQMB
PCCM
presumptive
retroactive
STAR+PLUS
THSteps medical checkup
verification
Women's Health Program (WHP)
Client enrollment
managed care
PCCM
STAR Program
Client lift
Clients with Medicare/Medicaid
prior authorizations
Clinical Laboratory Improvement Amendments (CLIA)
Clinical nurse specialist
benefits and limitations
claims filing
resources
enrollment
reimbursement 1 2
Clinical pathology consultations
Clinical records
Clinician-directed care coordination services
Comprehensive Care Program (CCP)
Clofarabine
Closing a prior authorization
CMS-1500
claim form (blank)
electronic billing
instruction table
paper billing
CNS
see Clinical nurse specialist
Cochlear implants 1 2 3 4
prior authorization
Cochlear Implants 1 2
Coding
CDT 1 2 3
CPT
HCPCS
independent laboratories, pathologists, radiologists
nonspecific
place of service (POS) 1 2
precoding paper claims
procedure coding
type of service (TOS)
Colony stimulating factors
filgrastim
pegfilgrastim
sargramostim
Colorectal cancer screening 1 2
colonoscopies
average risk
high risk
genetic testing
sigmoidoscopies
Commodity supplemental food program
Communicable disease reporting 1 2
Community health centers (CHC)
Complaints and fair hearings
managed care
Complete blood count (CBC) 1 2
Complete eye examinations
Compliance with federal legislation
Comprehensive Care Program (CCP) 1 2
benefits and limitations
client eligibility
clinician-directed care coordination services
claims information
documentation requirements
medical home clinician telephone consult with specialist
specialist/subspecialist telephone consult with medical home clinician
face-to-face services
medically complex health care
multidisciplinary health care
non-face-to-face services
care plan oversight
clinician supervision of a home health client
clinician supervision of a hospice client
general requirements
medical conferences
medical team conference
other supervision
prolonged services
supervision of a nursing facility client
telephone consultation
prior authorization
reimbursement
clinician-directed care coordination services (CCP)
benefits and limitations
comprehensive outpatient rehabilitation facility (CORF)
benefits and limitations
claims information
documentation requirements
enrollment
prior authorization
reimbursement
diagnosis coding
documenation requirements
drug and medical device approval
durable medical equipment (DME)
accessories
benefits and limitations
cardiorespiratory apnea monitor
benefits and limitations
documentation requirements
prior authorization
claims information
croup tent
benefits and limitations
documentation requirements
prior authorization
DME certification and receipt form
documentation requirements
donor human milk
benefits and limitations
documentation requirements
prior authorization
electronic blood pressure monitoring device
benefits and limitations
documentation requirements
prior authorization
enclosed beds
benefits and limitations
documentation requirements
prior authorization
enrollment
equipment adjustments
equipment modification
equipment repairs
incontinence supplies
benefits and limitations
documentation requirements
prior authorization
medical nutritional products
benefits and limitations 1 2
documentation requirements
enteral nutritional products
prior authorization
mobility aids
benefits and limitations
coding
corner chairs
documentation requirements
feeder seats
floor sitters
limitations
portable lifts for outside the home
documentation
prior authorization
prior authorization
scooters
stroller ramps
documentation requirements
prior authorization
strollers
documentation requirements
prior authorization
travel chairs
pediatric hospital cribs
benefits and limitations
documentation requirements
prior authorization
pharmacies
phototherapy devices
benefits and limitations
documentation requirements
prior authorization
retroactive eligibility
policies specific to CCP
prior authorization
pulse oximeter
benefits and limitations
documentation requirements
prior authorization
purchase vs. rental
reflux wedges and slings
benefits and limitations
documentation requirements
prior authorization
reimbursement
special needs car seats
benefits and limitations
documentation requirements
prior authorization
travel restraints
benefits and limitations
documentation requirements
prior authorization
Early Childhood Intervention (ECI) (CCP)
enrollment
inpatient psychiatric hospital (freestanding)
benefits and limitations
claims information
clinical criteria for inpatient psychiatric care
continued stays
court-ordered services
documentation requirements
enrollment
continuity of eligibility through change of ownership
prior authorization
prior authorizations
denials
reimbursement
retrospective utilization review
utilization review
inpatient rehabilitation hospital (freestanding)
benefits and limitations
claims information
comprehensive treatment
documentation requirements
enrollment
continuity of eligibility through change of ownership
goal
prior authorization
reimbursement
client transfers
medical nutrition counseling services
benefits and limitations
claims information
documentation requirements
enrollment
prior authorization
reimbursement
occupational therapy (OT)
benefits and limitations
claims information
documentation requirements
enrollment
prior authorization
reimbursement
orthotics and prosthetics
benefits and limitations
corrective shoes
benefits and limitations
documentation
prior authorization
cranial molding orthotics
benefits and limitations
documentation requirements
prior authorization
dynamic splint
benefits and limitations
documentation requirements
prior authorization
enrollment
fittings
general documentation requirements
modifications
prior authorization
protective helmets
benefits and limitations
documentation requirements
prior authorization
reciprocating gait orthoses (RGO)
benefits and limitations
documentation requirements
prior authorization
removable shoe insert
benefits and limitations
documentation requirements
prior authorization
repairs
replacement
thoracic-hip-knee-ankle orthoses (THKAO)
benefits and limitations
claims information
documentation requirements
parapodium
benefits and limitations
prior authorization
reimbursement
standing frame/brace
benefits and limitations
vertical stander
benefits and limitations
training
wedges and lifts
benefits and limitations
documentation requirements
prior authorization
outpatient rehabilitation facility (ORF)
benefits and limitations
claims information
documentation requirements
enrollment
prior authorization
reimbursement
personal care services (PCS)
benefits and limitations
claims information
client eligibility
accessing the PCS benefit
primary practioner's role
documentation requirements
enrollment
place of service
prior authorization
provided in group settings
provider responsibilities
reimbursement
retrospective review
physical therapy (PT)
benefits and limitations
claims information
documentation requirements
enrollment
prior authorization
reimbursement
physician signature
prior authorization
private duty nursing
authorization appeals
authorization for revision of current services
benefits and limitations
CCP Prior Authorization Request Form
claims information
client/provider notification
criteria
amount and duration of PDN
client eligibility
medical necessity
place of service
retroactive client eligibility
documentation requirements
enrollment
home health plan of care
Nursing Addendum to Plan of Care (CCP) Form
prior authorization
initial requests
recertifications of authorizations
reimbursement
responsible adult or identified contingency plan requirement
retrospective review
skilled nursing visit
TPN administration education
start of care (SOC)
termination of authorization
School Health and Related Services (SHARS)
appealing denied claims
audiology
benefits, limitations, and prior authorization
billing units based on 15 minutes
billing units based on an hour
claims filing
counseling services
documentation requirements
eligibility verification
enrollment
Medicaid Managed Care enrollment
nonschool SHARS enrollment
nursing services
occupational therapy (OT)
overview
personal care services (PCS)
physical therapy (PT)
physician services
prior authorization
private school enrollment
psychological services
psychological testing
billing
record retention
reimbursement
speech therapy (ST)
description of services
provider and supervision requirements
referral
transportation services
speech therapy (ST)
benefits and limitations
claims information
documentation requirements
enrollment
prior authorization
reimbursement
therapy services
Comprehensive health center (CHC)
physician services
Comprehensive outpatient rehabilitation facility (CORF)
Computed tomography angiography (CTA)
authorization
benefits and limitations
Computed tomography imaging (CT)
authorization
benefits and limitations
Computer-aided detection (CAD)
Confidential information
Contact Center
TMHP
Contact lens
prosthetic eyewear
Contact TMHP 1 2 3
Continuous glucose monitoring (CGM)
prior authorization requirements
continuous passive motion device DME
prior authorization
Continuous positive airway pressure (CPAP)
Contraceptives
injectable
Contrast materials
benefits and limitations
prior authorization
Corneal bandage
Corneal topography
Corneal transplants
Corner chairs
Corporate Board of Directors Resolution
Corrective shoes
Cost report
Medicaid Audit
Cost reporting
federally qualified health center (FQHC)
hospital
CPAP
prior authorization
prior authorization renewal
CPM
pior authorization
CPT
CPW
see Case Management for Children and Pregnant Women
Crime Victims' Compensation Program
Crossover Reimbursement
Croup tent
Custom commode chair
Custom manual wheelchair
prior authorization
Cytogam
Cytogenetics testing for leukemia and lymphoma
Cytopathology studies other than gynecological
D
Darbepoetin alfa
DARS, blind services
addresses
contact information
Date of service (DOS)
Day surgery
Deferoxamine mesylate (Desferal)
Dental
ADA claim form
instruction table
adjunctive general services
anesthesia 1 2
criteria 1 2
claims filing
claim form (paper) billing
client eligibility
client rights
dental home
dentures
diagnostic services
doctor of dentistry practicing as a limited physician
electronic claim billing
emergency services
clients over 21 1 2
fee schedule
first dental home
general information
handicapping labiolingual deviation (HLD)
HLD score sheet 1 2
hospitalization
ICF-MR dental services
provisions
implant services
informed consent
mandatory prior authorization
Medicaid Managed Care enrollment
oral/maxillofacial surgery
orthodontic procedure codes
orthodontic services
comprehensive treatment
mandatory prior authorization
special orthodontic appliances
transfer of services
treatment plans
periodicity
periodontal services
preventive services
prophylaxis
prosthodontics, removable
provider enrollment
radiographs
referrals
reimbursement 1 2
restorations
services
space maintenance (passive appliance)
supernumerary tooth identification
tests and examinations
therapeutic services
third-party resources
THSteps dental services 1 2 3 4
provisions
THSteps guidelines
TMHP information and assistance
tooth identification (TID) and surface identification (SID)
treatment plans
utilization review
Dentist (Doctor of Dentistry)
Dentures
Department of Assistive and Rehabilitative Services (DARS), Blind Services
Depo-Provera
Diabetic supplies
limitations
procedure codes
Diagnosis coding
Diagnosis requirements
portable X-ray supplier
radiological and physiological laboratory
Diagnostic tests
Dialysis 1 2 3
claim form example
Dimercaprol
Direct supervision
Disease panels
DME benefits for Medicare/Medicaid clients
DME home health services
augmentative communication device (ACD) system
benefits limitations prior authorization
prior authorization
supply procedure codes
DME medical supplier
cancellation
Doctor of dentistry
claims filing
claim form example
limited physician
diagnosis codes
mandatory prior authorization
Medicaid Managed Care enrollment
Document requirements and retention
prior authorization
Donor human milk
Doppler studies
Drugs
reimbursement
Drugs and supplies
outpatient services
DSHS offices
addresses
contact information
public health regions
contact information
map
Dual eligibility, Medicare and Medicaid
Durable medical equipment (DME)
accessories (home health)
bath and bathroom equipment
blood pressure devices 1 2
Breast pumps
claims filing
claim form example (CCP)
cochlear implants
continuous passive motion device
modifications (home health)
reimbursement
Dynamic splint
E
Early Childhood Intervention (ECI)
claim form example (CCP only)
Comprehensive Care Program (CCP)
referral
referrals
reimbursement
statutory requirements
Echoencephalography
Echography
Edetate calcium disodium
Edetate disodium
EDI
EDX testing
see electrodiagnostic (EDX) testing
EFT Authorization
Electric lift
Electrical percussor
prior authorization
Electrocardiogram (EKG)
Electrodiagnostic (EDX) testing 1 2
authorization requirements
electromyography (EMG)
maximum number of studies
nerve conduction studies (NCS)
reimbursement
Electromyography (EMG)
electrodiagnostic (EDX) testing
Electronic blood pressure monitoring device
Electronic claims submission
see TMHP EDI
Electronic Data Interchange
see EDI and TMHP EDI
Electronic data interchange (EDI)
advantages of electronic services
automated maintenance process
electronic billing
electronic services
electronic transmission reports
forms
gaining access
provider check amounts
software
supported file types
third party billing agents
third party vendor implementation
training
Electronic eligibility transactions
Electronic funds transfer
advantages
enrollment procedures
using
Eligibility
client
managed care
Medicaid
medical transportation
refer to type of provider
see also client eligibility
Emergency
emergency care restrictions
restricted coverage
Enclosed beds
Endodontics 1 2
Endoscopy
bronchoscopy
cystourethroscopy
endoscopic retrograde cholangiopancreatography (ERCP)
lower gastrointestinal endoscopy
sinus endoscopy
upper gastrointestinal endoscopy
Enrollment
advanced practice registered nurse (APRN)
ambulance
ambulatory surgical center (ASC)
certified registered nurse anesthetist (CRNA)
certified respiratory care practitioner (CRCP)
chiropractic services
clinical nurse specialist (CNS)
criteria for out-of-state providers
DME home health services
electronic funds transfer
federally qualified health center (FQHC)
hospital
hospital ambulatory surgical center (HASC)
independent laboratory
nurse practitioner (NP)
physical therapist
physician
physician assistant (PA)
portable X-ray supplier
provider
radiological and physiological laboratory
rural health clinic (RHC)
tuberculosis clinic
managed care program
vision care
Enteral nutritional products 1 2
limitations procedure codes
Enteral supplies
Epidural, implantable infusion pumps
Epoetin alfa (EPO)
EPSDT
see also Texas Health Steps (THSteps)
Esophageal pH probe monitoring
Exceptions-to-periodicity checkup, Texas Health Steps (THSteps)
External insulin pumps
documentation requirement
prior authorization
Extracorporeal membrane oxygenation (ECMO)
eye examinations for the purpose of prescribing eyewear
F
False claims recovery
employee education
Familial adenomatous polyposis
Family Planning 2017 Claim Form
Family planning services
claims information
instructions
laboratory handling fees
PCCM
physician services
reimbursement
Sterilization Consent Form 1 2
Federal financial participation (FFP)
reimbursement
Federally qualified health center (FQHC)
benefits and limitations 1 2
after-hours care
migrant farm workers
claims filing 1 2
claim form example 1 2 3
claims resources
cost reporting 1 2
documentation requirements
enrollment
Medicare-Medicaid crossover claims pricing
prior authorization 1 2
reimbursement 1 2
Fee schedules
dental
orthodontic
Feeder seats
Ferritin
Filgrastim
Filing deadlines
95-day 1 2
TPR
TPR 110-day rule
Floor sitters
Fluocinolone acetonide 1 2
Forms 1 2 3
1120 Medical Bills Transmittal
Abortion Certification Statements Form
Abortion Certification-Statements
American Dental Association (ADA) claim form
instruction table
behavioral health
Extended Outpatient Psychotherapy/Counseling Request Form
Psychological/Neuropsychological Testing Request Form
Birthing Center
Birthing Center Report (Form 7484)
CCP
ECI Request for Outpatient Therapy
Prior Authorization Request for Non-Face-to-Face Clinician-Directed Care Coordination Services
Prior Authorization Request Form
Private Duty Nursing 6 Month Authorization
Claims
Family Planning
Maternity Clinic
Nurse Practitioner/Clinical Nurse Specialist
Client Eligibility
CMS-1500
Crossover Type 30 claim form (MRAN)
Crossover Type 30 claims
instructions
Crossover Type 31 and 50
instructions
DME Certification and Receipt Form 1 2 3
Donor Human Milk Request Form
Extended Outpatient Psychotherapy/Counseling Request Form
External Insulin Pump 1 2
Federally Qualified Health Center Report (Form 7484)
Form Pb-109 Physician Reference on Follow-up Testing and Case Management
Hearing Evaluation, Fitting, and Dispensing Report (Form 3503)
Home Health
Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form
Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form
Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form Instructions
Home Health Services Plan of Care (POC) 1 2 3
Plan of Care 1 2
Prior Authorization Checklist 1 2
Home Health Plan of Care
Hospital Report (Form 7484) 1 2
Hysterectomy Acknowledgement
Hysterectomy Acknowledgment Form 1 2
Medicaid Certificate of Medical Necessity for Chest Physiotherapy Devices
Extended Request
Initial Request
Medicaid Certificate of Medical Necessity for CPAP/BiPAP or Oxygen Therapy
Medicaid Certificate of Medical Necessity for Reduction Mammaplasty
Medicaid Identification
Medicaid Identification (Form H3087) 1 2 3
Medicaid verification letter (Form H1027-A)
Medicaid verification letter (Form H1027-B)
Medicaid verification letter (Form H1027-C) 1 2
Nonemergency Ambulance Prior Authorization Request 1 2
Nursing Addendum to Plan of Care
Physician's Examination Report
Psychiatric Hospital Inpatient Initial Admission Request Form
Psychiatric Inpatient Extended Stay Request Form
Pulse Oximeter Form 1 2
Radiology Prior Authorization Request Form 1 2
Request for Extension of Outpatient Therapy (Form TP-2)
Request for Initial Outpatient Therapy (Form TP-1)
Special Medical Prior Authorization (SMPA) Request
Specimen submission
Statement for Initial Wound Therapy System In-Home Use
Sterilization Consent Form 1 2
English 1 2 3
instructions
Instructions
Spanish 1 2 3
Texas Health Steps
Child Health Clinical Records
Child Health History
Child Health Record
13 Months-2 Years
2-6 Months
3-5 Years
6-10 Years
7-12 Months
Birth-1 Month
claim forms
Dental Criteria for Dental Therapy Under General Anesthesia 1 2
Dental Mandatory Prior Authorization Request 1 2 3
Hearing Checklist for Parents
Hearing Checklist for Parents (Spanish
laboratory
Mental Health Interview Tool/Referral Form
0-2 Years
Ages 10-12 Years
Ages 13-20 Years
Ages 3-9 Years
Mental Health Parent Questionnaire
Ages 10-12 Years
Ages 10-12 Years (Spanish)
Ages 13-20 Years
Ages 13-20 Years (Spanish
Ages 3-9 Years
Ages 3-9 Years (Spanish)
Ages Birth-2 Years
Ages Birth-2 Years (Spanish)
PPD Agreement for Texas Health Steps Providers
Referral Form
Referral Form Instructions
Risk Assessment for Lead Exposure Parent Questionnaire, Form Pb-110 1 2
Specialist or Subspecialist Telephone Consultation Form for Non-Face-to-Face Clinician-Directed Care Coordination Services-Comprehensive Care Program (CCP)
Tuberculosis Questionnaire
Tuberculosis Questionnaire (Spanish)
TVFC Patient Eligibility Screening Record
TVFC Patient Eligibility Screening Record (Spanish)
TVFC Provider Enrollment
TVFC Questions and Answers
THSteps
Dental Mandatory Prior Authorization Request
UB-04 CMS 1450
Ventilator Service Agreement
Vision Care Eyeglass Patient Certification Form
English
Spanish
Wheelchair Seating Assessment Form 1 2
Wound Therapy System In-Home Use
Recertification
Fraud and abuse
fines
suspected cases
Fraud and abuse policy
Functional MRI (fMRI)
G
Gait trainers
Gamma globulin/immune globulin
Genetic testing
colorectal cancer screening
Genetics
benefit schedule
claims filing
claim form example
genetic evaluation and counseling
reimbursement 1 2
Global services
ambulatory surgical center (ASC)
hospital ambulatory surgical center (HASC)
Gonorrhea
Group clinical visits
asthma
diabetes
physician
Growth hormone
Guidelines for procedures awaiting rate hearing
Gynecological services
abortions
prior authorization
anesthesia
assays for vaginitis
claims
documentation
hysterectomy
acknowledgment
hysteroscopy
masculinized females
Pap smear
H
HCPCS
see Healthcare Common Procedure Coding System (HCPCS)
Health Insurance Premium Payment (HIPP) Program
managed care
Health maintenance organization (HMO)
Healthcare Common Procedure Coding System (HCPCS)
Hearing aid and audiological services claims
Hearing aid devices
30-day trial period
enrollment
facility visits and home visits
fitting and dispensing visits and revisits
implantable
limitations and required forms
medical necessity
non-implantable 1 2
noncovered services
reimbursement
replacement
supplies and accessories
warranty repairs and modifications
Hearing aid devices and accessories
Hearing aids and audiometric evaluations
claim form example
enrollment
reimbursement
Hearing devices
services/benefits, limitations and prior authorization
Hearing diagnostic services
Hearing screening
early hearing detection and intervention
Hearing screenings
additional
Hearing services
documentation requirements
Medicaid HMO claims
physician diagnostic
Heart disease classifications
Heart transplants
Heavy duty commode chair
Heavy duty wheelchair
prior authorization
Helicobacter pylori (H. pylori)
Hematopoietic agents
Hematopoietic injections
Hemoglobin type
Hepatitis B immunizations
Hereditary nonpolyposis colorectal cancer (HNPCC)
HFCWCS
documentation requirements
HHSC
claims filing
payment deadline
Complaints
DSHS-BHO services
HMO services
complaints and fair hearings
complaints to HHSC fee-for-service
fee-for-service and PCCM
administrative claim appeals
exception requests
exception to the 120-day appeal deadline
exception to the 95-day filing deadline
exceptions to the 24-month payment deadline
Provider complaints
Policy
procedures
utilization review
medical necessity appeals
PCCM
utilization review (UR)
admissions
continued stay denials
DRG changes
technical denials
HHSC offices
addresses
contact information
High-volume providers
reimbursement
HIV/AIDS
HIV testing
CDC recommendations for testing
pregnant women
state agencies
testing
testing procedure codes
where to go for help
workplace guidelines
abililty to work
accomodation
assistance
confidentiality and privacy
coworker concerns
development
discrimination
employee education
employment rights
governance
performance standards
Home health (DME)
manual wheelchairs
reimbursement
Home health agency
pending agency certification
Home health servcies
DME repairs
Home health services
benefit period
benefits
blood glucose monitors
canceling an prior authorization
catheters
certification
change of address/telephone number
claim form example
DME/medical supplies
skilled nursing visit and physical therapy
skilled nursing visits
claims information 1 2
benefit code
client evaluation
corner chairs
criteria for grouping levels
decubitus care accessories
documentation requirements
durable medical equipment (DME)
enrollment
enteral feeding pumps
exclusions 1 2
external insulin pump and supplies
feeder seats
floor sitters
group 1 support surfaces
group 2 support surfaces
group 3 support surfaces
home health aide services
home health aide visits
hospital beds and equipment
hospital beds and equipment procedure code
incontinence equipment
incontinence supplies and equipment
insulin and insulin syringes
intravenous (IV) therapy equipment and supplies
limitations
manual wheelchairs
heavy duty and extra heavy duty
standard, standard hemi, standard reclining, tilt-in-space
medical supplies
medication administration limitations
mobility aids
mobility aids that are not a benefit
nursing and therapy
enrollment
nursing services
nutritional (enteral) products, supplies, and equipment
nutritional supplies and equipment procedure codes and limitations
occupational therapy
prior authorization procedures
physical therapy services
possible Medicare clients 1 2
pressure reducing support services
prior authorization 1 2 3
prior authorization external insulin pump and supplies
professional nursing
prohibition of Medicaid payment 1 2
pulsatile jet irrigation wound care system
reimbursement
respiratory equipment and supplies
procedure codes and limitations
retroactive eligibility 1 2
sealed suction wound care system
services, benefits, limitations, and prior authorization
skilled nursing and home health aid services provider responsibilities
skilled nursing and home health aide services assessments and reassessments
skilled nursing and home health aide services not prior authorizated
skilled nursing and home health aide services prior authorization requirements
skilled nursing care
skilled nursing visits
supervision of home health aides
supplies submitted with a plan of care
travel chairs
vocational nursing
wound care
supplies
systems
criteria
thermal system
written plan of care
Home health services (DME)
incontinence supplies
Home health services POC
physician supervision
Home Health SN and Home Health Aide (HHA) Services
Home mechanical ventilation equipment
Home oxygen therapy
documentation requirements
Hormone injections
Hospice Medicaid Identification
Hospice Program
claims filing
Hospital
ambulance services
change of ownership 1 2
claims filing
client transfer
cost reporting
day surgery services
emergency department services
enrollment
general information
inpatient claim form example
inpatient reimbursement
newborn services
observation to inpatient admission
outliers
outpatient
claim form example
outpatient claims information
outpatient reimbursement
outpatient services
reimbursement
revenue codes (outpatient)
services
abortion
aerosol treatment
chemotherapy
cochlear implants
colorectal cancer screening
contraction stress testing
fetal nonstress testing
Helicobacter pylori
hyperbaric oxygen therapy
hysterectomy services
laboratory services
pentamidine aerosol
pulmonary function studies
radiation therapy
radiology services
tetanus injections, acute care
teaching hospitals
third party liability reporting
Hospital ambulatory surgical center (HASC)
benefits and limitations
claims resources
cochlear implants
colorectal cancer screening
documentation requirements
enrollment
fluocinolone acetonide
global services
implantable infusion pump
prior authorization
reimbursement 1 2
surgery
incomplete procedures
Hospital beds
documentation requirements
prior authorization
Hospital beds and equipment
home health services
Hospital visits
physician services
Human donor milk
Human rabies immune globulin (HRIG)
Human rabies vaccine
Humidification Units
Hydraulic lift
Hyperbaric oxygen therapy (HBOT), physician services
Hyperlipidemia
Hysterectomy
Acknowledgment Statement
claims filing instructions
I
ICD-9-CM
Ilizarov device, physician services
ImmTrac 1 2
how to report records
Immune globulin (Cytogam)
Immunizations
administrations and immunizations
free vaccines
general recommendations
hepatitis B
how to report records
human rabies immune globulin (HRIG)
physician services
recommended childhood schedule
requirements for TVFC
Texas Health Steps
TVFC requirements
Vaccine Adverse Event Reporting System (VAERS)
Immunosuppressive drugs
Implantable hearing aid devices
Implantable hearing devices
sound processor replacement
Implantable infusion pumps 1 2
Implants
cochlear implants
fluocinolone acetonide intravitreal
infusion pump
In-home total parenteral nutrition
reimbursement
Incontinence
equipment 1 2
procedure codes with limitations
supplies 1 2
documentation requirements
prior authorization
Independent laboratory
benefits and limitations
chemistry tests
claims filing
claim form example
electronic filing
clinical laboratory improvement amendments (CLIA)
Physician-performed microscopy procedure (PPMP) certificates
waiver certificates
complete blood count (CBC)
dialysis
disease panels
documentation requirements
enrollment
ferritin
iron studies
lab handling fees
laboratory paneling
organ panels
prior authorization
Prior authorization
independed laboratory
reference labs
reimbursement 1 2
repeated procedures
Texas Health Steps
outpatient services
urinalysis
Independent practitioners
reimbursement
Indian Health Services
reimbursement
Indian Self-Determination and Education Assistance Act
Informational claims 1 2
Injectable contraceptives
Injection port
prior authorization
Injections
abatacept (Orencia)
allergy
amifostine
antibiotics and steroids
antihemophilic factor
botulinum toxin type A
chelating agents
dimercaprol
edeferoxamine mesylate (Desferal)
edetate calcium disodium
edetate disodium
clofarabine
Depo-Provera
filgrastim
gamma globulin/immune globulin
growth hormone 1 2
hematopoietic agents 1 2
darbepoetin alfa
epoetin alfa (EPO)
hormones
immunosuppressive drugs
implantable infusion pumps
interferon
iron
joint and trigger point
leuprolide acetate (Lupron Depot)
maternal serum alpha-fetoprotein
omalizumab
paclitaxel
pegfilgrastim
sargramostim
trastuzumab
Integrated Care Management (ICM)
Interferon
Intermittent positive-pressure breathing (IPPB) treatment
Internal control number (ICN)
Intestinal transplants
Intraocular lenses 1 2
Intraoperative MRI (iMRI)
Intrathecal infusion, implantable infusion
Intravitreal drug delivery system
IPPB devices
prior authorization
Iridectomy/iridotomy/trabeculectomy
Iron dextran
Iron injections
Iron studies
Iron sucrose (Venofer)
IRS W-9 Form
IV equipment
prior authorization
IV supplies
documentation requirements
J
JCIH 2007 position statement
Joint injections
L
Lab handling fees
Laboratory
follow-up care guidelines
hyperlipidemia
required tests for medical checkups
newborn screening 1 2
see also Independent laboratory
supplies
THSteps services
Laboratory forms
Laboratory handling fees
family planning services
Laboratory paneling
Laboratory services 1 2
blood counts
clinical lab panel implementation
clinical pathology consultations
handling fee
LCSW
see Licensed clinical social worker (LCSW)
Lead poisoning
Lead screening
forms
measuring blood lead levels
prevention materials
procedures
symptoms of lead poisoning
Leuprolide acetate (Lupron Depot)
Level 1 group
Levels for custom manual wheelchairs
Licensed clinical social worker (LCSW)
behavioral health services
see Behavioral health
reimbursement
Licensed marriage and family therapist (LMFT)
behavioral health services
see Behavioral health
reimbursement
Licensed professional counselor (LPC)
behavioral health services
see Behavioral health
reimbursement
Licensed psychological associate (LPA)
behavioral health services
see Behavioral health
Licensure renewal
Limitations, Medicaid Program
noncovered procedures
Limited status claims payment
Linezolid
Liver transplants
LMFT
see Licensed marriage and family therapist (LMFT)
Local health departments
contact information
LPC
see Licensed professional counselor (LPC)
Lung transplants
Lung volume reduction surgery (LVRS)
M
Magnetic resonance angiography (MRA)
authorization
benefits and limitations
Magnetic resonance imaging (MRI)
authorization
benefits and limitations
Maintenance of provider information
Mammography
Managed care
advance directives
after-hours guidelines
automatic reenrollment
behavioral health
claims filing
electronic
paper
STAR
pregnant women
client eligibility
client enrollment
client responsibilities
clients rights and responsibilities
advance directives
responsibilities
rights
complaints and fair hearings
continuous coverage
cultural competency
eligibility
Health Insurance Premium Payment (HIPP) Program
health plan changes
HMO plan changes
administrator-initiated
client-initiated
limited English proficiency
overview
primary care provider
eligible provider types
primary care provider changes
requirements
prior authorization
provider requirements and information
provider-to-client ratio
see also PCCM
STAR Program 1 2
STAR+PLUS Program
third party resources
unacceptable telephone arrangements
Manual pricing
Manual wheelchair
custom
pediatric
prior authorization
Manual wheelchairs
seating assessment
Mastectomy
Maternal and child health
services block grant program
Maternal serum alpha-fetoprotein
Maternity care
Maternity clinics
provider enrollment
high-risk individuals
physician responsibility
reimbursement
services, limitations, prior authorization
claims
documentation
initial antepartum care
assessment
education
history
laboratory tests
physical exam
plan
postpartum care
prior authorization
subsequent antepartum care
laboratory
physical exam
MAXIMUS
Medicaid for breast and cervical cancer, client eligibility
Medicaid HMO prior authorizations
Medicaid Identification
Form H3087
Medicaid Program Administration
Medicaid Qualified Medicare Beneficiary (MQMB)
Medicaid relationship to Medicare 1 2
Medicaid verification letter
see Forms
Medicaid, Texas Program
client eligibility
fraud and abuse policy
medical necessity, definition
requirements for participation
restricted coverage
services provided outside Texas
verification documents
Medical checkup (THSteps)
birth through 20 years of age
laboratory
supplies
procedures and tests 1 2
Medical home
concept
mobile units
Medical nutrition counseling
Medical nutritional counseling
CCP claim form example
Medical nutritional products
Medical supplies
prior authorization
Medical supplies and wound care system
prior authorization
Medical transportation
contacting MTP
eligibility
Form H3113 Health Care Provider Statement of Medical Need
program limitations 1 2
program services
requirements
verification of service
Medically Needy Program (MNP)
claims filing
closing MNP case
spend down processing 1 2
Medicare
claims
claims deadlines
crossover reimbursement
Part A
Part B
fraud and abuse policy
Medicare and Medicaid DME prior authorization
Medicare and Medicaid Prior Authorization 1 2
Medicare Part C
Medicare/Medicaid
renal dialysis facility
Mental health claims
STAR+PLUS
Migrant health centers
Military hospital
benefits and limitations
claim form example (emergency inpatient)
claims information
enrollment
inpatient services
reimbursement
Mobile commode chair
level 2
Mobile units
enrollment
medical
Mobility aids
not a benefit
prior authorization
procedure codes and limitations
Modifications to durable medical equipment (DME) home health
Modifier 76 1 2
Modifier 91 1 2
Modifiers
anesthesia
MTP
See Medical transportation
Mucous clearance valve
reimbursement
Muscular Dystrophy Association
Myocardial perfusion imaging
Myocardial perfusion pool imaging
N
National Drug Code (NDC) 1 2 3
outpatient services
National Provider Identifier
Nebulizers
prior authorization
Negative pressure ventilators
prior authorization
Neglect
reporting
staff training
Nerve conduction studies (NCS)
electrodiagnostic (EDX) testing
Neurostimulators 1 2
Newborn
blood screening
claim hints
hearing screening
1-3-6 Month Practitioner's Guide
birth screen
ECI referral
evaluation
monitoring
outpatient rescreen
instructions
screening, statutory requirements
services 1 2
circumcisions
THSteps examination
Newborn Eligibility
Non-implantable hearing aid devices
Non-prosthetic contact lenses
Non-prosthetic eyeglass lenses
Non-prosthetic eyewear
frames, lenses, and contact lenses
Medicare coverage
replacement
vision services
Noncovered Services
Hearing Aids
Nonemergency Ambulance Prior Authorization Request Form
NorthSTAR Program
behavioral health billing
claims filing
client eligibility
client enrollment
complaints and appeals
enrollment broker
guidelines for working with NorthSTAR clients
hospital billing
overview
prior authorization requirements
provider requirements
quality improvement monitoring
service area
NP
see nurse practitioner
NPI
NPI Verification
Nurse
see certified nurse midwife, nurse practitioner, clinical nurse specialist, or certified registered nurse anesthetist
Nurse practitioner
benefits and limitations
claims filing
resources
enrollment
reimbursement 1 2
Nursing facility
admission
Nursing services
Nutritional products
documentation requirements
prior authorization
O
Observation
less than 24 hours
outpatient
Observation services 1 2
Obstetrics/prenatal care
Occupational therapy
School Health and Related Services (SHARS)
services
Occurrence codes for UB-04 CMS-1450
Office visit with lab and radiology
claim form examples
Omalizumab
Online enrollment
Online Fee Lookup (OFL)
Online prior authorizations
MedSolutions
Online Provider Lookup (OPL) 1 2
Ophthalmic ultrasound, sonography, and echography services
Ophthalmological services
Ophthalmology 1 2
Ophthalmoscopy
Opticians
reimbursement
Optometric services
diagnosis limitations
Optometrists
reimbursement
Oral surgery
Orencia
see Abatacept (Orencia)
Organ panels
Organ procurement
Organ transplant
Orthodontic services
mandatory prior authorization
procedure codes
special orthodontic appliances
Orthotic and prosthetic services
claim form example
Osteogenic stimulation 1 2
documentation requirements
invasive electrical osteogenic stimulator
noninvasive electrical osteogenic stimulator
prior authorization
professional services
ultrasound osteogenic stimulator
Osteopathic manipulation treatment (OMT)
OT Limitations
OT procedure codes
Time intervals
OT Services
OT, PT, and ST
documentation requirements
Other Ophthalmological Services
Vision Services
Other/Special Provisions
Out-of-state Medicaid providers 1 2
reimbursement
Outliers
cost outlier
day outlier
Outpatient
physician services in an outpatient hospital setting
Outpatient facilities
reimbursement
Outpatient rehabilitation facility (ORF)
Outpatient services
claims resources
drugs and supplies
global services
implants
cochlear implants
fluocinolone acetonide intravitreal
infusion pump
National Drug Code (NDC)
neurostimulators
prior authorization
surgery
incomplete procedures
Oxygen therapy
home delivery system types
prior authorization
recertification
P
Paclitaxel
Pap smear
Parapodium
Parental accompaniment 1 2
statutory requirements
Patient Acknowledgment Statement
Payment error rate measurement (PERM) 1 2
Payment Information
PCCM 1 2
access and availability standards
admissions
authorization
definitions
denials and appeals (inpatient)
facility services
inpatient
professional services (inpatient)
behavioral health services
inpatient
outpatient
case management fee
claims filing
specialist services
client eligibility
client enrollment
client responsibilities
community health services
complaints and appeals
authorization appeals
conflict resolution
provider complaints
contact numbers
covered services
behavioral health services
family planning services
OB/GYN services
Texas Health Steps
vision services
credentialing committee
action
frequency and logistics
grievance committee
members
enrollment
ER services
facility/hospital services
FQHCs and RHCs
reporting medical staff changes to TMHP
linguistic services
monthly member panel report
notification of admission 1 2
newborns
scheduled admissions
observation services
office and medical record standards
confidentiality of medical records
content of medical record
medical records audit
provider site requirements
office and medical records standards
out-of-network inpatient services
overview
primary care provider
primary care provider selection
responsibilities
services to be provided
verifying assignment
primary care providers
additional criteria
prior authorization
outpatient
procedures requiring
requesting
prior authorizations
provider enrollment
provider responsibilities
referrals
client self-referred services
referral form
referral network
specialist-to-specialist
reimbursement
emergency outpatient services
network hospitals
non-emergency outpatient clinic services
out-of-network hospitals
PCCM claims details
specialists responsibilities
support services
client support and education
providers
transportation services
nonemergency
PCCM+PLUS
client rights
client rights and responsibilities
goals
plan of care (POC)
services offered
PE Medicaid Identification
Pediatric hospital cribs
Pediatric nurse practitioner
see nurse practitioner
Pediatric pneumogram
Pegfilgrastim
Pentamadine, aerosol
Percutaneous transluminal coronary intervention
Performing provider
Periodicity schedule (THSteps)
birth through 20 years of age
exceptions to
medical checkup
PERM
Personal care services 1 2 3
School Health and Related Services (SHARS)
Personal supervision
Pharmacy
client limited
Phototherapy devices
Comprehensive Care Program (CCP)
see Comprehensive Care Program (CCP)
Physical examinations, sports
Physical status descriptions
Physical therapists 1 2
claim form example
enrollment
reimbursement 1 2
services
Physical therapy
claim form examples (CCP only)
Physician
behavioral health services
see Behavioral health
claims filing
comprehensive health centers (CHC)
dentistry, doctor of
domiciliary, rest home, or custodial care
emergency department services
enrollment
evaluation and management services
group clinical visits
asthma
diabetes
home services
inpatient hospital services
concurrent care
hospital admissions, initial visits, and subsequent visits
hospital discharge
nursing facility services
observation
intermittent positive-pressure breathing (IPPB)
kidney transplant
office or other outpatient hospital services
consultation services
new and established patient services
observation services
preventive care visits
services outside of business hours
outpatient hospital reimbursement
prior authorization
procedures and services
pulse oximetry
referrals
see also PCCM, referrals
reimbursement 1 2
services
aerosol treatment 1 2
allergy
allergy immunotherapy
allergy testing
direct nasal mucous membrane test
inhalation bronchial challenge testing
ophthalmic mucous membrane test
patch or application tests
percutaneous and intracutaneous skin test
photo or photo patch skin test
RAST/MAST tests
anesthesia
claims filing
complicated
for labor and delivery
for THSteps dental
modifiers
multiple procedures 1 2
pain management
provided by the surgeon
reimbursement
Bacillus Calmette-Guérin (BCG) for treatment of bladder cancer
bariatric surgery
prior authorization requirements
cancer
breast cancer screening
cancer screening and testing
cardiopulmonary resuscitaiton (CPR)
casting
chemotherapy
procedure codes
circumcision
cochlear implants
colorectal cancer screening
sigmoidoscopies
colorectal screening
colonoscopies
average risk
high risk
genetic testing
continuous glucose monitoring (CGM)
prior authorization
corneal transplants
diagnostic tests
ambulatory blood pressure monitoring
ambulatory electroencephalogram (A/EEG)
bone marrow aspiration
cytopathology studies other than gynecological
echoencephalography
electrocardiogram (EKG)
electrodiagnostic (EDX) testing
esophageal pH probe monitoring
Helicobacter pylori (H. pylori)
myocardial perfusion imaging
pediatric pneumogram
doppler studies
endoscopy
bronchoscopy
cystourethroscopy
endoscopic retrograde cholangiopancreatography (ERCP)
lower gastrointestinal endoscopy
sinus endoscopy
upper gastrointestinal endoscopy
extracorporeal membrane oxygenation (ECMO)
eye surgery
incision
laser
family planning
Helicobacter pylori
hospital visits
hyperbaric oxygen therapy (HBOT)
Ilizarov device
immunizations
human rabies immune globulin (HRIG)
human rabies vaccine
injections
abatacept (Orencia)
amifostine
antibiotics and steroids
antihemophilic factor
botulinum toxin type A
chelating agents
deferoxamine mesylate (Desferal)
dimercaprol
edetate calcium disodium
edetate disodium
clofarabine
filgrastim
gamma globulin/immune globulin
growth hormone
hematopoietic agents
darbepoetin alfa
epoetin alfa (EPO)
hormones
immunosuppressive drugs
implantable infusion pumps
interferon
iron
joint and trigger point
leuprolide acetate (Lupron Depot)
omalizumab
paclitaxel
pegfilgrastim
sargramostim
trastuzumab
intraocular lenses
laboratory
blood counts
clinical lab panel implementation
clinical pathology consultations
handling fee
long term care nursing facility
magnetic resonance angiography (MRA)
magnetic resonance imaging (MRI)
mastectomy and breast reconstruction
maternity care
neuromuscular electrical stimulation (NMES)
neurostimulators
doral column neurostimulator (DCN)
intracranial neurostimulators (ICN)
NMES and TENS supplies
NMES/TENS garments
percutaneous electrical nerve stimulators (PENS)
prior authorization
sacral nerve stimulators (SNS)
transcutaneous electrical nerve stimulators (TENS)
newborn
noninvasive diagnostic studies
nuclear medicine
obstetrics/prenatal care
occupational therapy
ophthalmology 1 2
orthognathic surgery
physical therapy
radiation therapy
radiology
reduction mammoplasties
renal disease
speech-language therapy
splinting
stereotactic radiosurgery
strapping
telemedicine
transplant prior authorization
vaccinationsee Immunizations
vagal nerve stimulators (VNS)
ventilation assist and management
sign language interpreting services
substitute physician
supervision
teaching attending physician and resident physician
supplies, trays, and drugs
visits
wearable cardiac defibrillator
Physician assistant (PA)
benefits and limitations
claims filing
resources
enrollment
reimbursement 1 2
Physician oversight services
Physician services
School Health and Related Services (SHARS)
Physician-performed microscopy procedure (PPMP) certificates
Physiological laboratory
reimbursement
Podiatrist services
clubfoot casting
flat foot treatment
routine foot care
Portable X-ray supplier 1 2
benefits and limitations
claims filing
resources
contrast materials
enrollment
prior authorization
radiology procedures
cardiac blood pool imaging
CT/CTA
fMRI
iMRI
MRI/MRA
myocardial perfusion imaging
PET scans
radiation therapy
radiopharmaceuticals
reimbursement 1 2
Positive airway pressure system devices
Positron-emission tomography (PET) scans
brain imaging
prior authorization
tumor imaging
Power elevating leg lifts
documentation requirements
Power seat elevation system
documentation requirements
Power wheelchairs
custom
documentation requirements
standard
Preferred Provider Organization (PPO)
Premature infants
eligibility
Prenatal care
Prescription pads
Prescriptions
VDP
delivery
Pressure-reducing support surface
documentation requirements
Presumptive eligibliity process
Primary Care Case Management
Primary care provider
see Managed care
Prior authorization
ambulance 1 2 3
emergency out-of-state transport
nonemergency
retroactive eligibility
ambulatory surgical center (ASC)
certified respiratory care practitioner
Comprehensive Care Program (CCP)
continuous glucose monitoring (CGM)
contrast materials
CT/CTA
federally qualified health center (FQHC) 1 2
forms
Addendum to Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form
CCP ECI Request for Outpatient Therapy
CCP Prior Authorization Private Duty Nursing 6 Month Authorization
CCP Prior Authorization Request for Non-Face-to-Face Clinician-Directed Care Coordination Services
CCP Prior Authorization Request Form
Donor Human Milk Request Form
Extended Outpatient Psychotherapy/Counseling Request Form 1 2
External Insulin Pump 1 2
Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form
Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form Instructions
Home Health Services Plan of Care (POC) 1 2 3
Home Health Services Plan of Care (POC) Instructions 1 2
Home Health Services Prior Authorization Checklist 1 2
Medicaid Certificate of Medical Necessity for Chest Physiotherapy Devices
Extended Request
Initial Request
Medicaid Certificate of Medical Necessity for CPAP/BiPAP or Oxygen Therapy
Medicaid Certificate of Medical Necessity for Reduction Mammaplasty
Nonemergency Ambulance Prior Authorization Request
Plan of Care
Home Health
Psychiatric Hospital Inpatient Initial Admission Request Form
Psychiatric Inpatient Extended Stay Request Form
Pulse Oximeter Form 1 2
Radiology Prior Authorization Request Form
Request for Extension of Outpatient Therapy (Form TP-2)
Request for Initial Outpatient Therapy (Form TP-1)
THSteps Dental Mandatory Prior Authorization Request Form 1 2 3 4
home health services (DME)
hospital ambulatory surgical center (HASC)
independed laboratory
managed care
mandatory prior authorization (dental)
MRI/fMRI/MRAPrior authorization
PET scans
neurostimulators
NorthSTAR Program
orthodontic services
outpatient services
PCCM outpatient prior authorization
physician
portable X-ray supplier
programmable pumps
radiological and physiological laboratory
radiopharmaceuticals 1 2
renal dialysis
renal dialysis facility
rural health clinic (RHC) 1 2
THSteps and ICF-MR dental prior authorization
tissue transplant services
transplants
tuberculosis clinic 1 2
Prior Authorization of Retroactive Eligibility
Prior authorizations
closing
denials appeals process
Medicaid HMO
MedSolutions
notification
PET scans
requests by FAX, telephone, or mail
requests by mail
requests for clients with private insurance
requests for clients with retroactive eligibility
requests for newly enrolled providers
requests through the TMHP website
requirements for hearing aid devices
retroactive eligibility
terms and condition
Private duty nursing
claim form examples (CCP only)
Private Pay Agreemen
Procedure codes
CPT (level I)
HCPCS codes (level II)
levels of codes
noncovered
orthodontic
THSteps dental 1 2 3
tuberculosis
DOT/DOPT examination
initial examination
Professional providers
reimbursement
Prognostic breast and gynecological cancer studies
Programmable pumps, prior authorization
Prosthetic contact lenses
Prosthetic eyewear 1 2
dispensing requirements
Medicare coverage
replacement and repair
Prosthodontics
fixed
removable
Protective helmets
Provider
education
out-of-state
professional organizations
resolution of problems
Provider enrollment
application 1 2
Disclosure of Ownership and Control of Interest Statement
group information changes
group practices
Medicaid Audit Information Form
PCCM 1 2
miscellaneous provisions
termination/disenrollment
provider agreement
provider responsibilities
required forms
STAR and STAR+PLUS Programs
Medicaid Managed Care Programs
Texas Health Steps (THSteps)
Provider Information Change (PIC) Form
Provider reenrollment
Provider responsibilities
billing requirements
certification
child support
compliance with
Americans with Disabilities Act of 1990
Civil Rights Act of 1964
Rehabilitation Act of 1973
confidential information
incidental services
medical record documentation requirements
patient acknowledgment statement
procedures for reporting
abuse or neglect
suspected sexual abuse
retention of records
training
tuberculosis clinic
utilization control
vision care
Provider-specific visits
reimbursement
Providers Liens for Third Party Reimbursement
Psychiatric Hospital/Facility
claim form example (Inpatient - CCP only)
Psychologist
behavioral health services
see Behavioral health
reimbursement
PT
limitations
procedure codes
services
Public health districts
contact information
Pulse oximeter
prior authorization
Pulse oximetry 1 2
Pumps, implantation
Q
Qualified Medicare Beneficiary (QMB) 1 2 3 4
Qualified provider enrollment
presumptive eligibility
Quick Reference Guide
Texas Health Steps
R
Rabies post-exposure prophylaxis (PEP)
Radiation services
Radiation therapy
benefits and limitations
brachytherapy
claim form example
claim form examples
procedure code limitations
Radiological and physiological laboratory
benefits and limitations
claims filing
resources
contrast materials
enrollment
prior authorization
radiology procedures
cardiac blood pool imaging
CT/CTA
fMRI
iMRI
MRI/MRA
myocardial perfusion imaging
PET scans
radiation therapy
radiopharmaceuticals
reimbursement
Radiological and physiological laboratory and portable X-ray supplier
claim form examples
Radiological laboratory
reimbursement
Radiology and laboratory services
general information
Radiology prior authorizations
MedSolutions
Radiology services 1 2 3
benefits and limitations
diagnosis requirements
physician-performed services
therapeutic radiopharmaceuticals
Radiopharmaceuticals
benefits and limitations
prior authorization
RAST/MAST tests
physician
Rate hearings, guidelines for procedures awaiting
Reciprocating gait orthoses (RGO)
Record retention
rural health clinic (RHC)
Reduction mammoplasties
Reference labs
Referrals
Case Management for Children and Pregnant Women (CPW)
family planning
genetic services
PCCM
THSteps 1 2
THSteps dental
Reflux, slings, and wedges 1 2
prior authorization
Refunds
Other insurance payments
Registered nurse
additional THSteps educational requirements
Texas Health Steps (THSteps)
Rehabilitation
Rehabilitation hospital
claim form example (inpatient - CCP only)
Rehabilitation hospital (freestanding) (CCP)
reimbursement
Rehabilitative services
Reimbursement 1 2
ambulance
ambulatory surgical center (ASC) 1 2 3
case management
for children and pregnant women
for children who are blind and visually impaired
for early childhood intervention
certified nurse-midwife
certified registered nurse anesthetist
certified respiratory care practitioner
chemical dependency treatment facility
chiropractic services
clinical nurse specialist
cost reimbursement
dental 1 2
drugs/biologicals
durable medical equipment
family planning services
federal financial participation (FFP)
federally qualified health center (FQHC) 1 2
genetic services
hearing aid and audiometric evaluations
Hearing Services
high-volume providers
home health services
hospital
hospital ambulatory surgical center (HASC) 1 2
in-home total parenteral nutrition
independent laboratory 1 2
independent practitioners
Indian Health Services
licensed clinical social worker
licensed marriage and family therapist
licensed professional counselors
manual pricing
maternity service clinic
Medicare crossover
Part A
Part B
methodology
nurse practitioner
opticians
optometrists
out-of-state medicaid providers
outpatient facilities
personal care services
physical therapists 1 2
physician 1 2
physician assistant 1 2
physician services in outpatient hospital setting
physiological laboratory
portable X-ray supplier 1 2
professional providers
provider-specific visits
psychologist
radiological and physiological laboratory
radiological laboratory
reasonable cost/interim rates
renal dialysis facility 1 2 3
rural health clinic (RHC) 1 2
School Health and Related Services (SHARS) 1 2
certification of funds
cost reconciliation and cost settlement
cost reporting
random moment time study (RMTS)
static fee schedules
THSteps
tuberculosis clinic 1 2
tuberculosis clinics
vision care
vision services
Reimbursement methodology
anesthesia
Remittance and Status (R&S) Report
adjustments to claims
banner pages
claims being processed
claims payment summary
delivery options
examples
accounts receivables
adjustments
appendix
backup withholding penalty information
banner page
claims in process
IRS levy
manual payouts
paid or denied claims
hospital
physician
refunds
Managed Care
Medicaid
reissues
sub-owner recoupments
summary
system payouts
void and stop pay
explanation of benefit codes
explanation of columns
explanation of pending status codes
field explanation
financial items
internal control number (ICN)
paid or denied claims
section explanation
status of claims
title pages
see banner pages
Renal dialysis
documentation requirements
prior authorization
Renal dialysis facility
annually
benefits and limitations
CAPD
claim form example (CAPD/CCPD) 1 2
claim form example CMS-1500
claims filing 1 2
claims resources
composite rate
dealing direct-support services
enrollment
every 3 months
every 6 months
every month
in-facility dialysis
nonroutine laboratory
routine laboratory
laboratory services
maintenance
CAPD and CCPD
hemodialysis
IPD
Medicare/Medicaid
per dialysis
per month
per week
prior authorization
radiology services
reimbursement 1 2 3
revenue codes
training
CAPD
CCPD
hemodialysis
IPD
Renal disease
Repairs to client-owned equipment
Repeated procedures
Replacement of equipment/accessories
Reporting abuse and neglect, statutory requirements for
Reporting waste, abuse, and fraud
Reservoirs, impantation
Respiratory care
Respiratory equipment
prior authorization
Respiratory equipment and supplies
Retroactive eligibility
see Client eligibility
Revenue codes
renal dialysis facility
Root canal therapy
Routine hearing screenings
Rural health clinic (RHC)
after-hours care
benefits and limitations
claims filing
claim form example, freestanding 1 2
claim form example, hospital-based
claims information
claims resources
cost reporting 1 2
documentation requirements
enrollment
freestanding 1 2
hospital-based 1 2
prior authorization 1 2
record retention
reimbursement 1 2
S
Sargramostim
School Health and Related Services (SHARS)
claims filing
claim form examples
personal care services
reimbursement
Scooters 1 2
documentation requirements
prior authorization
Screening services
hyperlipidemia
lead
Screening, brief intervention, and referral to treatment (SBIRT)
Seat lift mechanisms
documentation requirements
Seating assessment
documentation requirements
prior authorization
Seating assessments
manual wheelchairs
Second opinions
Secretion clearance devices
Self-dialysis
Services
Presumptive Eligibility
Services/Benefits, Limitations and Prior Authorization
Vision Care
SHARS Audiology Services
Sign language interpreting services, physician
Signature
client
provider 1 2
Signature authority
Silver nitrate applicators
Skin testing
tuberculosis
Sodium ferric gluconate complex in sucrose (Ferrlecit)
Somatrem
Somatropin
Sonography
Special Medicaid Prior Authorization (SMPA) Request Form
Special needs car seats 1 2
Special needs travel restraints
Special ophthalmological services
Speech therapy
School Health and Related Services (SHARS)
Speech-language pathology
claim form examples (CCP only)
Speech-language therapy
Spend down, Medically Needy Program
Sports physical examinations
ST and Aural Rehabilitation Services
Stale-dated checks
Standard manual wheelchair
prior authorization
Standard power wheelchair
documentation requirements
Standers
documentation requirements
Standing frame/brace
STAR Health Program
benefits
claims filing
claims submissions
mental health rehabilitation
client eligibility
overview
STAR Health model
STAR Program
benefits
adult well check
prescription drugs
spell of illness
claims filing
newborn claims submission
client enrollment
newborns
assignment of Medicaid ID
THSteps
HMO model
managed care
overview
service areas
STAR+PLUS Program
benefits
claims filing
client eligibility
dual eligible clients
ineligible clients
enrollment of newborns
HMO model
managed care
mental health claims
overview
service area
spell of illness limitation
State Legalization Impact Assistance Grant (SLIAG)
State requirements
early childhood intervention (ECI)
parental accompaniment
reporting abuse and neglect
Texas Health Steps
newborn blood screening
State Supported Living Centers
Stationary commode chair
level 1
Statutory requirements
communicable disease reporting
Early Childhood Intervention (ECI)
newborn screening
parental accompaniment
reporting abuse and neglect
teen confidentiality issues
Texas Health Steps (THSteps)
STD testing
Stem cell transplants
Stereotactic knife radiosurgery
Sterilization
consent form 1 2 3
attachment to claims
services
subcutaneous injection port
documentation requirements
Subcutaneous injection port
prior authorization
Subcutaneous injection ports
Submission of birth information
Submission of informational claims
third party reimbursement
Submitting claims for services that require prior authorizations
Supplemental Security Income (SSI)
Surgery
anesthesia administered by surgeon
assistant surgeons
bariatric
prior authorization requirements
bilateral procedures
biopsy
cosurgery 1 2
global fees
global surgery concurrent care
incomplete procedures
lung volume reduction
multiple
office procedures
orthopedic hardware
primary
prostate
second opinions
Syphilis testing
T
Tamper-resistant prescription pads
Tax Equity and Fiscal Responsibility Act (TEFRA)
physician reimbursement
Taxonomy codes 1 2
TB
see Tuberculosis
Teen confidentiality issues, statutory requirements
TEFRA
see Tax Equity and Fiscal Responsibility Act (TEFRA)
Telemedicine
Telephone numbers
DARS, blind services 1 2
DSHS offices
federal and state
HHSC
client communication
PCCM
community health services
inpatient/outpatient prior authorization line
member helpline
nurse line
provider helpline
STAR Help Line
STAR Program
TMHP
Temporary license/certification
Terminal illness, Medicaid services unrelated to
Texas Band of Kickapoo Equity Health Program
Texas Board of Nursing (BON)
Texas early hearing detection and intervention (TEHDI)
Texas Family Code
Texas Health Steps
claim forms
communicable disease reporting
dental guidelines
AAPD Periodicity Guidelines
early hearing detection and intervention
ECI referral
forms
Child Health History
Child Health Record
13 Months-2 Years
2-6 Months
3-5 Years
6-10 Years
7-12 Months
Birth-1 Month
Form Pb-109 Physician Reference on Follow-up Testing and Case Management
Hearing Checklist for Parents
Hearing Checklist for Parents (Spanish)
How to Determine Tuberculosis Risk
Mental Health Interview Tool/Referral Form
0-2 Years
Ages 10-12 Years
Ages 13-20 Years
Ages 3-9 Years
Mental Health Parent (Spanish)
Mental Health Parent Questionnaire
Ages 10-12 Years
Ages 10-12 Years (Spanish)
Ages 13-20 Years
Ages 3-9 Years
Ages 3-9 Years (Spanish)
Ages Birth-2 Years
Ages Birth-2 Years (Spanish)
PPD Agreement for Texas Health Steps Providers
Tuberculosis Questionnaire
Tuberculosis Questionnaire (Spanish)
TVFC Patient Eligibility Screening Record
TVFC Patient Eligibility Screening Record (Spanish)
TVFC Provider Enrollment
TVFC Questions and Answers
hearing monitoring
immunizations
exemption for schools and child-care facilities
Immunizations
exemption for schools and child-care facilities
free vaccines
general recommendations
ImmTrac
recommended childhood schedule
immunizations overview
JCIH 2007 position statement
lead screening 1 2
prevention education and forms
newborn blood screening
newborn hearing screening 1 2
outpatient laboratory services
parental accompaniment
Quick Reference Guide 1 2
reporting abuse and neglect
state legislative requirements
tuberculosis
screening and education tool
tuberculosis skin testing
TVFC versus non-TVFC vaccines/toxoids
Texas Health Steps (THSteps)
administrative information
assistance contacts
cervical cancer screening
claims filing
claim form examples
THSteps medical checkup
diagnosis and treatment claim form example
client eligibility
Comprehensive Care Program (CCP)
claim filing resources
dental
eligibility
emergency dental referrals
referrals
routine dental referrals
services
dental program
exceptions-to-periodicity checkup
laboratory services
laboratory supplies
medical checkup
documentation
eligibility
facilities
periodicity schedule, birth-20 years of age
verification
medical home concept
mobile units
newborn
required components of examination
periodicity schedules
provider enrollment
referrals
registered nurse
additional education requirements
reimbursement
newborn examination
required laboratory screening procedures
STAR Program enrollment
statutory requirements
statutory state requirements
STD testing
Texas immunization registry
Texas Kidney Health Care Program
Texas Medicaid
administration
Texas Medicaid & Healthcare Partnership (TMHP)
Texas Medical Assistance Program (Medicaid)
Texas Medical Review Program (TMRP)
Texas Vaccines for Children (TVFC) Program
TexMedConnect 1 2
electronic billing
training
The Stewart McKinney Act
Therapeutic apheresis
Therapeutic phlebotomy 1 2
Therapists, independent practitioners and physicians
enrollment
services benefits limitations and prior authorization
Therapy in a Nursing Facility
Third party reimbursement
Third Party Liability
Third party reimbursement
Third Party Resources (TPR)
110-day rule 1 2
accident-related claims
adoption cases
claims filing
deductibles
HMO copayments
other insurance
claims forward to other insurance carriers
other insurance credits
dental
filing deadlines 1 2
hearing services
managed care
nonsources
sources
third party billing agents
THSteps requirements
vendor implementation
verbal denial
Workers' Compensation
Title XIX Family Planning
Claims
Billing for non-family planning services during family planning visit
National Drug Code
guidelines
services, limitations, prior authorization
annual exams
reimbursement
contraceptives
capsules
external
intrauterine device
occlusive sterilization
drugs and supplies
injections
prescriptions
labratory
documentation
reference labratory
requirements
specimen handling
medical counseling
outpatient visits
reimbursement
radiology
undocumented and legalized aliens
Titles V, X, XX
Claims
Deadlines
National Drug Code
Reimbursement
Title X
Third-party resource
Title X Encounter
Documentation
Provider enrollment
Providers
Services, Limitations, Prior Authorization
Annual exams
Reimbursement
Contraceptives
Capsules
External
Intrauterine Device
Medroxyprogesterone Acetate/Estradiol Cypionate
Drugs and supplies
Prescriptions
Education
Natural family planning
Nutritional Therapy
Laboratory
Titles V, XX
Outpatient
Reimbursement
Prior Authorization
Radiology
Sterilization
Anesthesia
Consent
Incomplete sterilization
Tubal ligation
Vasectomy
TMHP
Contact Center
TMHP EDI
batch numbers
Help Desk
Julian dates
newborns
paper claims
resubmitting rejections
TMHP Provider Relations
TMHP Website
Tooth identification (TID) number
Tort
Tort Response Form
Total Parenteral Nutrition (TPN) Solutions 1 2
TPN
documentation requirements
prior authorization
TPR
see Third party resources
Tracheostomy tubes
prior authorization
Tracheostomy Tubes
Training
Transfers of client
Transplants
heart
intestinal
liver
lung
services
stem cell
Transportation services
School Health and Related Services (SHARS)
Trastuzumab
Travel chairs
Travel restraints
Trigger point injections
Tuberculosis
How to Determine Tuberculosis Risk
reimbursement
screening and education tool
Tuberculosis clinic
ancillary services
benefits and limitations 1 2
claims filing 1 2
claim form example
claims resources
documentation requirements
enrollment
prior authorization 1 2
provider responsibilities
reimbursement 1 2
X-ray
Tuberculosis skin testing
Texas Health Steps
Tumor imaging
benefits and limitations
TVFC
see Texas Vaccines for Children
TVFC requirements
TVFC versus non-TVFC vaccines/toxoids
Type of service (TOS) 1 2
U
UB-04 CMS-1450
claim form (paper) billing
electronic billing
instruction table
Undeliverable eyewear
Undocumented aliens
Urinalysis
Utilization review
dental
V
Vaccinations
see Immunizations
Vaccine Adverse Event Reporting System (VAERS) 1 2
Vaccines
TVFC
Vagal nerve stimulators
Vaporizers
prior authorization
Vendor Drug Program (VDP)
72-hour emergency supply
claims
cost avoidance COB
medically necessary drugs and supplies
Palivizumab (Synagis)
participating pharmacies
prescriptions
controlled substances
delivery
tamper-resistant prescription pads
Ventilator service agreement
documentation requirements
prior authorization
Ventilators
prior authorization
Verifying Prior Authorization Status
Vertical stander
Vestibuloplasty
Vision
claim form example
optometrists
reimbursement 1 2
Vision care
services performed in long- term care facilities
Vision services
corneal transplants
documentation requirements
noncovered services and supplies
services not reimbursed separately
Volume ventilators
prior authorization
W
W-9 Form
Waiver Certificates
Waste, abuse, and fraud
reporting
Wearable cardiac defibrillator
Wedges and lifts
Wheelchair
levels
Wheelchair batteries
battery charger
prior authorization
Wheelchair ramp (portable and threshold)
Wheelchairs
prior authorization
Women, Infants, and Children (WIC)
Women's Health
Documentation requirements
Provider enrollment
Services, Limitations, Prior Authorization
Annual exam
Reimbursement
Contraceptives
Drugs and supplies
Prescriptions
Eligibility
Laboratory
Natural family planning
Outpatient
Reimbursement
Radiology
Sterilization
Anesthesia
Consent
Facilities
Hysteroscopic
Tubal ligation
WHP
Abortions
Guidelines
Referrals
Breast and cervical cancer clients
Breast and cervical cancer screenings
WHP claims
National Drug Code
Reimbursement
third-party resource
Women's Health Program (WHP)
Workers' Compensation 1 2
Wound care
prior authorization
procedures and limitations
supplies 1 2
documentation requirements
system
documentation
systems
X
X-ray
chest
tuberculosis
  
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