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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 10 PCCM and Managed Care Claims Processed by TMHP Before March 1, 2012 : 10.1 PCCM Appeals

10.1
The following types of managed care claims must be appealed to TMHP and not the MCO or dental plan:
Providers can find benefit, limitation, and claims filing information in the appropriate Texas Medicaid Provider Procedures Manual or Texas Medicaid website article for the dates of service on the claim.

Texas Medicaid & Healthcare Partnership
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