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Family Planning 2017 Claim Form Revision
Information posted April 11, 2007: The Family Planning 2017 Claim Form for paper billers has been revised for the implementation of the National Provider Identifier (NPI). Effective May 21, 2007, all Title V, Title X, and Title XX family planning providers and any participating Texas Medicaid Program providers who currently use the Family Planning 2017 claim form must use the revised version of the Family Planning 2017 Claim Form for claim submissions and appeals, regardless of the version used for prior submissions. Claims submitted on the revised version of the Family Planning 2017 Claim Form before May 21, 2007, will be returned to the provider.
Details of these changes are available on the TMHP website at www.tmhp.com and will be available in the May/June 2007 Texas Medicaid Bulletin.
For more information, call the TMHP Contact Center at 1-800-925-9126.
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