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December 2016 Texas Medicaid Provider Procedures Manual

Section 2: Texas Medicaid Fee‑for‑Service Reimbursement : 2.4 Using Payouts to Satisfy Accounts Receivables Across Programs and Alternate Provider Identifiers : 2.4.1 HHSC Recoupment of Accounts Receivables from Alternate Provider Identifiers

2.4.1
HHSC recoups the outstanding accounts receivable balances of all existing Medicaid and managed care Texas Provider Identifiers (TPIs) from alternate TPIs that use the same Tax ID or National Provider Identifier (NPI).
If a Medicaid or managed care provider has a TPI that is no longer active or has been terminated and that TPI has an outstanding accounts receivable balance, the balance is recouped from future payments made to any and all TPIs that have the same Tax ID or NPI. Recoupments are reflected on future R&S Reports.
Note:
Refer to:
Subsection 2.2.5, “Accounts Receivable” in the Medicaid Managed Care Handbook (Vol. 2, Provider Handbooks) for additional information about managed care claims and outstanding accounts receivables.
Subsection 2.6.4, “Providers With Unsatisfied Medicaid Accounts Receivables” in the Medicaid Managed Care Handbook (Vol. 2, Provider Handbooks) for additional information about managed care claims and outstanding accounts receivables.

Texas Medicaid & Healthcare Partnership
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