What is on-line appeal submission?

On-line appeal submission is a method of submitting Texas Medicaid and CIDC appeals using the personal computer (PC). An appeal is a request for reconsideration of a previously dispositioned claim. The on-line appeals feature can be accessed by a business organization bridging directly into TexMedNet or by using TDHconnect, the free Windows-based software available from NHIC.

What are the advantages to on-line appeal submission?

Using on-line appeal submission provides the following advantages to the users:

• Increased accuracy of appeals filed to potentially improve cash flow
• Print and download capabilities help maintain audit trails
• Appeal submission windows can be automatically populated by electronic remittance and status report information, thereby reducing data entry time

How is this service accessed?

TexMedNet on-line appeal submission is available to business organizations (i.e., billing organizations, vendors and clearinghouses) interfacing directly with TexMedNet or through TDHconnect.

How will business organizations not using TDHconnect access TexMedNet?

Because no standards exist a proprietary format is used for submitting TexMedNet appeals. Texas specific formats are available for download from the TexMedNet Bulletin Board System (BBS).

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