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December 2016 Texas Medicaid Provider Procedures Manual

Section 6: Claims Filing : 6.4 Claims Filing Instructions : 6.4.2 Claim Form Requirements : 6.4.2.6 Newborn Clients Without Medicaid Numbers

6.4.2.6
If a Medicaid eligible newborn has not been assigned a Medicaid number on the DOS, the provider must wait until a Medicaid client number is assigned to file the claim. The provider writes the number instead of “Pending.” The 95‑day filing period begins on the “add date,” which is the date the eligibility is received and added to the TMHP eligibility file. Providers verify eligibility and add date through TexMedConnect or by calling AIS or the TMHP Contact Center at 1‑800‑925‑9126 after the number is received.
Providers must check Medicaid eligibility regularly to file claims within the required 95‑day filing deadline.
Refer to:

Texas Medicaid & Healthcare Partnership
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