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2012 Texas Medicaid Provider Procedures Manual

Inpatient and Outpatient Hospital Services Handbook : 3. Inpatient Hospital (Medical/Surgical Acute Care Inpatient Facility) : 3.7 Claims Filing and Reimbursement : 3.7.5 Third Party Liability

3.7.5
Hospitals and providers enrolled in Texas Medicaid are required to inform TMHP about circumstances that may result in third party liability for health‑care claims. After receiving this information, TMHP pursues reimbursement from responsible third parties.
Hospitals and providers must mail or fax the Other Insurance Form for Health Insurance or the Tort Response Form for accidents to the following address:
Texas Medicaid & Healthcare Partnership
TPL Correspondence
Third Party Liability Unit PO Box 202948
Austin, TX 78720‑2948
Fax: (512) 514-4225
Refer to:
Subsection 4.13, “Third Party Liability (TPL),” in Section 4, “Client Eligibility” (Vol. 1, General Information).
Form 4.4, “Other Insurance Form” in Section 4, “Client Eligibility” (Vol. 1, General Information).
Form 4.7, “Tort Response Form” in Section 4, “Client Eligibility” (Vol. 1, General Information).

Texas Medicaid & Healthcare Partnership
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