Provider Alert! New Claims Requirements Effective September 1, 2018
Date: August 20, 2018
New Claims Requirements Effective September 1, 2018
Attention: Network Providers
Billing taxonomy
Per section 6.2.1 of the TMPPM Billing providers must submit the taxonomy number on all electronic claims with the exception of Medicare primary claims. Electronic claims without a billing taxonomy will be rejected.
| Claim Requirement | Electronic Claim |
| Billing Provider Taxonomy Code (required on all claims) | 2000A, PRV03 |
Ordering/Referring Provider Requirement
For services that require an ordering/referring provider the NPI of the ordering/referring provider must be attested. Billing providers can verify an ordering/ referring provider NPI by using the provider search tool at http://opl.tmhp.com/ProviderManager/AdvSearch.aspx.
| Claim Requirement | Electronic Claim |
| Ordering/referring provider NPI | 2300, REF02 |
If you have any questions, please email Provider Network Management at providerrelations@texaschildrens.org.
For more information:
http://www.tmhp.com/TMHP_File_Library/FQHC/FQHC%20FAQs%20v2017.pdf
http://www.tmhp.com/Pages/ProviderEnrollment/PE_TX_Medicaid_New.aspx
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