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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 4: Client Eligibility : 4.13 Third Party Liability (TPL) : 4.13.3 Adoption Cases

4.13.3
If a claim is inadvertently sent to the adoption agency before it is sent to TMHP, TMHP must receive the claim within 95 days of the date of disposition from the adoption agency denial, payment, request for refund or recoupment, to be considered for payment.
Refer to:
Subsection 6.1.4, “Claims Filing Deadlines” in Section 6, “Claims Filing” (Vol. 1, General Information).
A copy of the non-TPR disposition must be submitted with the claim and received at TMHP within 95 days from the date of the disposition (denial, payment, request for refund, or recoupment of payment by the non-TPR source).

Texas Medicaid & Healthcare Partnership
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