Tex. HHSC Medicaid Hospice Provider Manual § 4510

Revision 06-2; Effective December 12, 2006

HHSC makes payment for hospice services to providers once TMHP has processed the claim. TMHP and HHSC will not pay the Medicaid hospice provider until all hospice forms and documents have been submitted, as outlined in Section 4100, General Information, and Section 4300, Withholding Payments. TMHP staff verify and approve all hardcopy hospice forms for data entry and payments to hospice providers. Forms must be mailed to the TMHP address below. Mailings to a different address, an incomplete address or any variation of this address may cause claims processing delays of four weeks or more.

Texas Medicaid & Healthcare Partnership

TMHP LTC Unit

P.O. Box 200765

Austin, TX 78720-0765

Address hospice billing questions to the TMHP Help Desk at 800-626-4117.

For dually eligible recipients, Medicare is always the primary payer. Medicaid pays only for service normally billed to Medicare if the recipient has exhausted his Medicare benefits. Documentation that shows Medicare denial must be submitted to HHSC before the Medicaid program pays for these services.