Provider Alert! Correction for new claim requirement
Effective October 1, 2019, all claims submitted to Texas Children’s Health Plan must be submitted with the member’s state provided Medicaid Identification Number and date of birth on the claim.
Providers should confirm the Medicaid Identification Number is submitted in block {1a} for CMS-1500 forms and block {60} of a CMS 1450 (UB-04). For electronic claims, the member Medicaid Identification Number should be submitted in Loop 2010BA for either the 837P or 837I.The member’s date of birth must also be included.
Claims missing the Member ID number on or after October 1st will be denied. This applies to all claims regardless of the method of submission (electronic or paper submissions).
Additional information regarding electronic submissions can be found on Texas Children’s Health Plan’s provider portal.
Texas Children’s Health Plan Professional Companion Guide
Texas Children’s Health Plan Institutional Companion Guide
Next steps for providers: Providers should coordinate this change with their contracted clearinghouse and billing staff.
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