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2012 Texas Medicaid Provider Procedures Manual

Clinics and Other Outpatient Facility Services Handbook : 2. Birthing Center : 2.2 Services, Benefits, Limitations, and Prior Authorization : 2.2.2 Newborn Eligibility Process

If the mother of the newborn is eligible for Medicaid, the newborn may be assigned his or her own Medicaid number. The birthing center must complete form GN.4, “Birthing Center Report (Newborn Child or Children) (Form 7484)” to provide information about each child born to a mother who is eligible for Medicaid.
Refer to:
If the newborn’s name is known, the name must be on the form. The use of “Baby Boy” or “Baby Girl” delays the assignment of a number.
The form must be completed by the birthing center no later than five days after the child’s birth. Birthing centers that submit the birth certificate information using the DSHS, Vital Statistics Unit (VSU) Texas Electronic Registrar for Birth software and the HHSC Form 7484 receive a rapid and efficient assignment of a newborn Medicaid identification number. This process expedites reimbursement to hospitals and other providers that are involved in the care of the newborn.
Additional information about obtaining a newborn Medicaid identification number can be found on the agency website at Providers may also call 1‑888-963-7111, Ext. 7368 or (512) 458-7368 for additional information or comments about this process.
Upon receipt of a completed 7484 form, DSHS verifies the mother’s eligibility and, within 10 days of the receipt, sends notification letters to the hospital or birthing center, attending physician (if identified), mother, and caseworker. The notice includes the child’s Medicaid identification number and the effective date of coverage. After the child has been added to the eligibility file, DSHS issues a Medicaid Identification card (Your Texas Benefits Medicaid card) to the client.
The attending physician’s notification letter is sent to the address on file (by license number) at the Texas Medical Board. This address must be kept current to ensure timely notification. Physicians must submit address changes to the following address:
Texas Medical Board
Customer Information, MC-240
PO Box 2018 Austin, TX 78767-2018

Texas Medicaid & Healthcare Partnership
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