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December 2016 Texas Medicaid Provider Procedures Manual

Section 6: Claims Filing : 6.2 TMHP Electronic Claims Submission : 6.2.2 Electronic Claim Acceptance

Providers should verify that their electronic claims were accepted by Texas Medicaid for payment consideration by referring to their Claim Response report, which is in the 27S batch response file (e.g., file name E085LDS1.27S). Providers should also check their Accepted and Rejected reports in the rej and acc batch response files (e.g., E085LDS1.REJ and E085LDS1.ACC) for additional information. Only claims that have been accepted on the Claim Response report (27S file) will be considered for payment and made available for claim status inquiry. Claims that are rejected must be corrected and resubmitted for payment consideration.
Refer to:
Subsection 3.2, “Electronic Billing” in “Section 3: TMHP Electronic Data Interchange (EDI)” (Vol. 1, General Information), visit, or call the EDI Help Desk at 1‑888‑863‑3638 for more information about electronic claims submissions.

Texas Medicaid & Healthcare Partnership
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