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HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 3

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Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) billing on behalf of consumer-directed services (CDS) have been submitting claims and forms to Texas Medicaid & Healthcare Partnership (TMHP). TMHP has received feedback from providers indicating additional support is required. Resolutions and current status regarding the most frequently reported issues may be found in the table below.

Topic

Current Status

Service Coordinator Dropdown Field

 

Providers have reported that dropdown fields on the following forms are not populating the correct Service Coordinator list:

  • Intellectual Disability/Related Condition (ID/RC) Assessment 8578
  • Individual Plan of Care (IPC) forms 3608 and 8582
  • Individual Movement Form (IMT)

TMHP is working with HHSC to resolve the issue. A follow-up article will be published on the TMHP Long-Term Care (LTC) webpage when the issue is resolved.

Topic

Resolution

 

Local Case Number Error Message

Providers have reported receiving an error message when entering the Local Case Number on the following forms: 

  • ID/RC Assessment 8578
  • IPC forms 3608 and 8582

The error message states “Individual’s identifying information is not valid. Please review individual’s identifying information and resubmit.”

HHSC is working to resolve this issue. A follow-up article will be published when the issue is resolved.

For more information, contact the LTC Help Desk at 800-626-4117 (select option 1, then option 7).

Topic

Resolution

Identifying Level of Care and Level of Need

Providers have requested assistance in identifying client Level of Care and Level of Need on the Medicaid Eligibility Service Authorization Verification (MESAV) and in the Centers for Medicare & Medicaid Services (CMS) Bill Code Crosswalk.

The approved Level of Care and Level of Need records for HCS and TxHmL appear on a client’s MESAV as follows:

  • HCS:
    • HC – Level of Care
    • HN – Level of Need
  • TxHmL:
    • XL – Level of Care
    • XN – Level of Need

In the CMS Bill Code Crosswalk Level of Care is identified as “LC” or “LOC”.

   

Topic

Resolution

Using the Line Item Control Number (LICN) Field

Providers submitting claims for HCS and TxHmL services using the TMHP claims submission tool, TexMedConnect, will need to use the LICN field to identify the individual who provided the HCS and TxHmL service. Proper use of the LICN field will prevent claim mismatches, denials, or rejections.

To locate the appropriate service for the LICN, providers should reference the HCS and Texas Home Living TxHmL Bill Code Crosswalk on the LTC Bill Code Crosswalks web page.

Providers can find step-by-step instructions on filling out the LICN field in the LTC User Guide for TexMedConnect, Appendix: Using the LICN Field for HCS and TxHmL Waiver Programs

Frequently asked questions about the LICN can be found in the HCS and TxHmL Waiver Programs Frequently Asked Questions document. Providers can find additional detailed information about submitting claims to TMHP in the HCS and TxHmL TexMedConnect Claims Submission Webinar recording.

 

View previous postings below:

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 2

HCS and TxHmL Waiver Programs: Trending Issue Support

Important Claims Submission Information for HCS and TxHmL Programs

LTC Online Portal Dashboard Accessibility Issue Resolved

IPC Forms 3608 and 8582 Issue Resolved

HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022

Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs

Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP

EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission

For additional questions, contact the TMHP LTC Help Desk at 800-626-4117, Option 1, then Option 7.