Beginning July 1, 2000, the Texas Department of Health is improving the process for claims processing and payment for Medicaid newborn services. This change was mandated by House Bill 2896 of the 76th Legislature. The improved process will allow for health plans to pay providers for services prior to receiving the newborn's State-issued Medicaid ID number. In order for the process to work, providers will need to bill the HMO, in which the mother of the newborn is a member. On the billing please use the mother's name and Medicaid ID number. The contract language below indicates the structure of how this process will work.

If you have any questions, please call the Medicaid managed care HMO in which your contract (if you are a provider) or the Texas Department of Health, Bureau of Managed Care at 512/794-6862 and ask to speak to Sheri Wilson.

The following are provisions from the TDH/HMO contract that provide detail on the newborn process:

6.9                   PERINATAL SERVICES