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 the Texas Medicaid & Healthcare Partnership (TMHP). TMHP has received feedback from providers and LIDDAs indicating that additional support is required. Resolutions regarding the most frequently reported issues are presented in the table below.
Topic |
Resolution |
Claim Details Cannot Overlap Multiple IPC Service Authorizations |
Providers and FMSAs were recently advised not to overlap multiple Individual Plan of Care (IPC) service authorization periods in claim details. Beginning July 26, 2023, claim details will be denied with edit F0268 if the dates of service (DOS) cross multiple IPC service authorization periods. Claims submitted with overlapping DOS prior to July 26, 2023, can be adjusted to split the affected claim detail into two separate details to ensure accurate utilization tracking. Note: For instructions on how to adjust claims, refer to the “Adjustments” section of the LTC User Guide for TexMedConnect. |
R&S Report Educational Materials |
Providers can refer to the Remittance and Status (R&S) Reports for LTC Providers Quick Reference Guide (QRG) for information about R&S reports. Additionally, a three-part educational video series is available on TMHP’s HCS and TxHmL YouTube playlist that discusses the following topics: · General R&S Report information and instructions for account administrators on how to set permissions for users to access R&S Reports (Part 1) · How to read and understand the first section of the R&S Report: Non-Pending Claims (Part 2) · How to read and understand the second, third, and fourth sections of the R&S Report: Pending Claims, Financial Summary, and EOB Codes and Descriptions (Part 3) |
Claims Data Export Issue |
An issue was identified with the Claims Data Export, causing data to incorrectly shift over by one column. Data from Column H (LINE_ITEM_CONTROL) populated in Column I (SUBMITTED_PROCEDURE), resulting in the data for each subsequent column to shift to the following column. This was corrected on July 27, 2023. For reports that were affected by this issue, the claims can be identified by filtering Column I (SUBMITTED_PROCEDURE) and selecting all values that are not procedure codes. Note: Instructions for using the Claims Data Export are available in the LTC User Guide for TexMedConnect. For further assistance, contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7). |
View previous postings below:
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 22
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 21
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 20
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 19
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 18
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 17
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 16
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 15
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 14
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 13
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 12
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 11
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 10
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 9
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 8
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 7
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 6
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 5
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 4
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 3
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 assistance with any further questions, contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7).