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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 6: Claims Filing : 6.14 Filing Medicare Primary Paper Claims

6.14
Providers are allowed to file Medicare primary paper claims to TMHP for payment of coinsurance or deductible for claims that fail to cross over from Medicare electronically.
Providers that receive paper MRANs from Medicare or a Medicare intermediary or MRANs using the CMS-approved software MREP, for professional services, or PC-Print, for institutional services, may submit these MRAN to TMHP. Providers that submit these MRANs are not required to submit the TMHP Standardized MRAN Form.
Providers that cannot retrieve the MRAN from MREP or PC-Print, or who don't receive a paper MRAN from Medicare or a Medicare intermediary, must submit the TMHP Standardized MRAN Form.
Providers that submit paper crossover claims must submit only one of the approved MRAN formats—MREP, PC-Print, paper MRAN from Medicare or a Medicare intermediary or TMHP Standardized MRAN form along with a completed claim form. Paper crossover claims that contain multiple MRAN forms with conflicting information are returned to the provider or denied.

Texas Medicaid & Healthcare Partnership
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