Letter 14-83 provides notification to all entities submitting claims to Texas Medicaid &
Healthcare Partnership (TMHP) via TexMedConnect or Electronic Data Interchange (EDI).
All updates discussed in this information letter are effective February 1, 2015.
Several fields are being added to accommodate administrative consolidation, ensure effective
sharing of data among the Health and Human Services Commission, the Department of Aging and
Disability Services, and their respective contractors, and maintain compliance with federal
regulations. Enhancements are being made to TexMedConnect to capture and validate the required
data.
All institutional claim templates and/or batches will be required to accommodate these updates.
Additionally, providers using the services of a third-party claims submitter must inform the thirdparty
submitter of these updates in order for claims to be successfully transmitted.
As of the date of this letter, providers must include the following claim information for successful
claim submission to TMHP via TexMedConnect:
· Attending Provider – National Provider Identifier or Atypical Provider Identifier of entity
providing care/service (existing field will now be edited)
· Patient Discharge Status – Identifies location of individual at the end of the billing cycle (new
field)
· Place of Service – Facility type (new facility type codes being added to current drop-down
box)
· Claim Frequency – Code indicating billing sequence (new field)
· Admit Date – Date individual admitted to facility (new field)
· Admitting Diagnosis Code – Individual’s diagnosis upon admission (new field)
Claim transactions submitted to TMHP via TexMedConnect on or after February 1, 2015, will
reject until all required information has been provided.
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