Texas Medicaid Program
HHSC Moves CHIP Cases into TIERS
CHIP cases are now in the TIERS eligibility system. This transition brings important changes for CHIP health care providers. By October 1, 2013, CHIP members will have a new CHIP ID number. Providers must bill CHIP services under the new CHIP ID number for services provided on or after October 1, 2013.
Providers must use the old alphanumeric CHIP ID number for services provided before October 1, 2013, with one exception. The exception is for CHIP Perinatal clients who enroll on or after September 3, 2013. These clients already have been issued the new ID number, and providers should immediately begin billing using the new CHIP ID number.
If a provider does not use the appropriate CHIP ID number to bill services, the claim will be denied. However, providers can appeal a claim denial using the standard appeals process.
The CHIP Managed Care Organizations must either issue clients a new member ID card or provide a sticker that can be placed on the current ID with the client’s new ID number. Clients should receive their new member ID card or sticker by October 1, 2013.
STAR+PLUS Enrollment Letters Sent in Error
An error resulted in STAR+PLUS enrollment packets being sent to some Department of Aging and Disability Services (DADS) waiver clients. The letters told the clients they needed to choose a plan because they would soon move into STAR+PLUS. These clients are getting a letter correcting this mistake. The new letter will say:
"We recently sent you a letter that said you would soon be in the Medicaid STAR+PLUS program. We sent you this letter by mistake. You do not need to take any action because of this. You will not be enrolled in STAR+PLUS at this time, even if you picked a medical plan and doctor."
HHSC also has directed the vendor that made the mistake to call affected clients to explain what happened. For questions, call 1-800-964-2777.
Responses Posted for Managed Transportation Organizations
HHSC's Medical Transportation Program has posted responses to questions collected during recent public forums regarding proposed opportunities for managed transportation organizations.
Parent Authorization Rule Delayed
HHSC is delaying implementation of administrative rules that restrict the adults that a parent or guardian may authorize to accompany their child to Texas Health Steps visits or on rides provided the Medical Transportation Program. Due to a recent court decision, HHSC will not begin enforcement of the rule as planned on April 1, 2013. Please be aware that the rule (§354.1133 of Title 1, Part 15 of the Texas Administrative Code) has not been repealed and HHSC may fully implement and enforce the rule at a later date.
For more information, call the TMHP Contact Center at 1-800-925-9126.
The Your Texas Benefits Medicaid Card: Information for Providers and Community Service Organizations
Providers can use the Your Texas Benefits Medicaid Card to verify a patient’s Medicaid eligibility. A person’s unique Medicaid ID number appears on the front of their card. That same number is embedded in a magnetic strip on the back of the card, accessible with a basic swipe-style card reader.
YourTexasBenefitsCard.com Frequently Asked Questions
Community Service Organizations
For more information about the new Your Texas Benefits Medicaid card or the new Medicaid eligibility verification website, call 1-855-827-3747.
Texas Medicaid Wellness Program
The goal of the Texas Medicaid Wellness Program is to help clients with long-lasting or serious health conditions improve their health. People who get traditional fee-for-service Medicaid can join the wellness program. The program includes nurses, pharmacists, social workers, behavioral health specialists, dieticians, certified diabetes educators and community health workers. For more information on the Wellness Program, visit the Texas Medicaid Wellness Program web page.
IMPROVE Gives New Voice to Medicaid Providers
Attention Medicaid Providers: HHSC wants to hear from you. Do you have an idea, issue, recurring, or suggestion about Texas Medicaid? If so, check out the IMPROVE system.
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