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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 2 Overview of Medicaid Managed Care : 2.7 Managed Care Plan Changes : 2.7.3 Managed Care Organization (MCO) Clients Who Transition to Medicaid Fee-For Service (FFS) : 2.7.3.1 Submission Guidelines

2.7.3.1
TMHP will consider the reimbursement of claims for services that were rendered on or after the MCO’s disenrollment date only when the provider submits a request to TMHP to transfer the previously approved authorization for CCP services. The request to TMHP must be received on or before the end date of the previously approved MCO authorization. Any requests submitted after the MCO’s authorization end date will have to meet the regular submission guidelines for the specific service type.

Texas Medicaid & Healthcare Partnership
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