June 2018

How to Keep the Cash Flowing: Review Sample Claim Forms to Ensure Accurate Submissions

In most cases, Blue Cross and Blue Shield of Texas’ (BCBSTX) coding mirrors the Texas Medicaid & Healthcare Partnership’s guidelines found in the most current Texas Medicaid Provider Procedures Manual. This is a great resource to understand if your claims are being submitted correctly. Billing information can also be found in BCBSTX provider manuals, which can be reviewed by provider type:

• STAR and CHIP members
• STAR Kids members

Follow up to Home Health Provider Claim Submission Tips Article
We would like to provide a follow up to the first article in this series, which focused on preventing claim delays for home health providers. In addition to making sure you know when to use the CMS-1500 and CMS-1450 forms, Patient Status 01 in box 17 of the CMS-1450 form should be completed. Also, Attending and Taxonomy codes are the two main reasons home health claims are denied. Please make sure these sections are completed on your claim forms before submitting.

If you have any questions regarding claim requirements, please contact the Texas Medicaid Network Operations Department at 1-855-212-1615 or at TexasMedicaidNetworkDepartment@bcbstx.com.