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2012 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : Appendix A: THSteps Forms : 3.1 Claim Forms

3.1
Claim Forms
Providers must order CMS‑1500 and American Dental Association (ADA) Dental Claims Forms from the vendor of their choice. Copies cannot be used. Claims filing instructions and examples of the claim forms are located in Section 6: Claims Filing (Vol. 1, General Information).
Refer to:
Subsection 6.5, “CMS‑1500 Paper Claim Filing Instructions” in Section 6, “Claims Filing” (Vol. 1, General Information).
Subsection 6.5.3, “CMS‑1500 Blank Paper Claim Form” in Section 6, “Claims Filing” (Vol. 1, General Information).
Subsection 6.7, “2006 American Dental Association (ADA) Dental Claim Filing Instructions” in Section 6, “Claims Filing” (Vol. 1, General Information).

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.