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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 3 School Health and Related Services (SHARS) : 3.5 Claims Filing and Reimbursement : 3.5.1 Claims Information

Claims for SHARS must be submitted to TMHP in an approved electronic claims format or on a CMS‑1500 claim form. Providers may purchase CMS‑1500 paper claim forms from the vendor of their choice. TMHP does not supply the forms.
Claims must be submitted within 365 days from the date of service, or no later than 95 days after the end of the Federal Fiscal Year (i.e., January 3), whichever comes first.
Refer to:
Section 3: TMHP Electronic Data Interchange (EDI) (Vol. 1, General Information) for information on electronic claims submissions.
Section 6: Claims Filing (Vol. 1, General Information) for general information about claims filing.
Subsection 6.5, “CMS‑1500 Paper Claim Filing Instructions” in Section 6, “Claims Filing” (Vol. 1, General Information) for instructions on completing paper claims.

Texas Medicaid & Healthcare Partnership
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