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December 2016 Texas Medicaid Provider Procedures Manual

Section 8: Third Party Liability (TPL) : 8.7 Tort : 8.7.3 Informational Claims

8.7.3
If providers determine that a third party may be liable for a Medicaid client’s accident-related claim, they can submit an informational claim to the TMHP Tort Department to indicate that a third party is being pursued for payment. This allows providers to secure the 95-day claims filing deadline in the event that the payment is not received from the third party.
TMHP processes informational claims for all claims administered by TMHP, including fee-for-service claims and carve-out services. TMHP does not process informational claims for managed care claims that are administered by the client’s MCO or dental plan.

Texas Medicaid & Healthcare Partnership
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