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December 2016 Texas Medicaid Provider Procedures Manual

Section 4: Client Eligibility : 4.2 Eligibility Verification : 4.2.1 Advantages of Electronic Eligibility Transactions

4.2.1
Eligibility transactions through TexMedConnect or EDI have the following advantages:
Submission of client group lists through TexMedConnect. Providers can create lists of clients to verify eligibility. Each client group can contain up to 250 clients, providers can create up to 100 groups for each National Provider Identifier (NPI).
Electronic eligibility responses contain:
Complete other insurance information, including name and address, and effective dates. EDI transactions also indicate the patient relationship to policy holder.

Texas Medicaid & Healthcare Partnership
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