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Resolved: Issues With Electronic Claims Submission for MCO Forward Claims and LTC TMC Claims View

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A recent error caused unexpected claim rejections between December 6, 2024, and December 13, 2024, for claims that were expected to be forwarded to managed care organizations (MCOs). The issue has now been resolved.

Providers that submitted electronic claims to the Texas Medicaid & Healthcare Partnership (TMHP) for forwarding to the MCOs and received one of the rejection codes below should resubmit their electronic claims to TMHP for forwarding to the MCOs.

The following rejection codes were sent as a result of the issue:

  • A1002 – The submitted claim number is invalid or has been purged if over 3 years old.
  • 00026 – Client is eligible for Medicare Part A, B, or C. Medicare must be billed first. Please review client eligibility to determine which Medicare carrier to bill.
  • 00310 – Service(s) filed on an incorrect claim form. Refer to provider procedures manual and refile as an original claim.

LTC Managed Care Claims Through TMC

Because of an unrelated issue, long-term care (LTC) managed care claims that were originally submitted through TexMedConnect (TMC) or directly to electronic data interchange (EDI) were not viewable in TMC.

This issue has now been resolved. LTC providers submitting MCO claims can now view the claims in TMC.

For more information, call the TMHP Contact Center at 800-925-9126 or LTC at 800-626-4117 or 800-727-5436.