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December 2016 Texas Medicaid Provider Procedures Manual

Section 8: Third Party Liability (TPL) : 8.8 Other Insurance Claims Filing

8.8
The following information must be provided in the “Other Insurance” field on the paper claim and in the appropriate field of electronic claims. On the CMS-1500 paper claim form, Blocks 9 or 11, and 29 must contain the appropriate information:
Important:
By accepting assignment on a claim for which the client has Medicaid coverage, providers agree to accept payment made by insurance carriers and Texas Medicaid when appropriate as payment in full. The client cannot be held liable for any balance or copays related to Medicaid-covered services.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2014 American Medical Association. All rights reserved.