Provider Alert! Attention: Early Childhood Intervention (ECI) Providers

Provider Alert!

Provider Alert! Attention: Early Childhood Intervention (ECI) Providers

Attention: Early Childhood Intervention (ECI) Providers
Effective Date: April 3, 2020

Call to action: In accordance with guidance from Texas Medicaid Provider Procedures Manual (TMPPM), providers must use the associated benefit code when submitting claims.

How this impacts providers: Changes in billing practices may be required if there are claim denials.

Next steps for providers: Billing reminders:

  • Providers should ensure that their claims submissions include their benefit code per TMHP guidelines.
  • If the taxonomy code is attested to a benefit code, the benefit code should be entered in SBR03 on an electronic claim and in 11c on a paper claim.
  • On the 837, the field for the benefit code is SBR03 (this information is showing in both the TCHP and TMHP 837 Companion Guides) and on a paper claim, the correct field is 11c (showing Section 8.5.4 CMS-1500 Instruction Table of TMPPM Section 6:  Claims Filing).

Resources:

TMPPM ECI Services

TCHP companion guide

TMHP 837 companion guide

TMPPM section 6: claims filing

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.
For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers

 

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