November 20th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 12
Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership (TMHP).
TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert.
October 17th, 2022
HCS and TxHmL Waiver Programs: Migration Trending Issue Support, Volume 10
October 7th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 9
Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership.
TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert
-Preventing claim denials for invalid date spans
Claims billed with date spans may deny with one of the following explanations of benefits (EOBs):
F0126: Claim line items cannot span current fiscal years.
The new state fiscal year (SFY) runs from September 1, 2022, through August 31, 2023. Claims will be denied with EOB F0126 if they are submitted with line item dates of service (DOS) spanning the previous SFY ending August 31, 2022, and the current SFY. Providers and LIDDAs submitting claims with DOS spanning the previous and current SFYs should submit separate claims for each SFY.
F0326: Incorrect number of days billed for this service.
Services that only allow billing for individual DOS may be denied with EOB F0326 if they are billed with date spans. These services should be billed as separate line items for each service date.
-Claims adjustments reminder
Claims that have processed successfully can be adjusted. For instructions on how to adjust claims, refer to the “Adjustment” section of the LTC User Guide for TexMedConnect.
Providers can also adjust a previously adjusted claim in TexMedConnect. For instructions, refer to HCS and TxHmL Waiver Programs: How to Adjust a Previously Adjusted Claim
September 11th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 8
-Termination Forms Submitted by LIDDAs
For clients who have CDS services only, termination forms are submitted by LIDDAs. After form submission, LIDDAs need to contact HHSC Program & Eligibility Support (PES) to acknowledge and review the forms. LIDDAs can contact HHCS PES by calling 512-438-2484, faxing 512-438-4249, or emailing enrollmenttransferdischargeinfo@hhs.texas.gov.
Read more on the following items:
–Long-Term Care Online Portal Sessions Must Be Restarted Daily
–Using the “Resubmit to SAS” Button
Access to Electronic R&S and PDF R&S Reports
August 31st, 2022
Migration Trending Issue Support Vol 7:
August 16th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support Volume 6
–Individual’s residential address in Individual Search
–“Pending LA Review” status and action needed
–Using the correct IMT Form to update the service coordinator (SC)
–HCS and TxHmL call queue
For info on these trending issues see the following link:
https://www.tmhp.com/news/2022-08-16-hcs-and-txhml-waiver-programs-trending-issue-support-volume-6
August 13th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support Volume 5
Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) that bill on behalf of consumer-directed services (CDS) have been submitting claims and forms to Texas Medicaid & Healthcare Partnership (TMHP). TMHP has received feedback from providers indicating that additional support is required.
Here are the latest resolutions to trending issues below:
HCS and TxHmL Call Queue
Status: When contacting TMHP, providers need to select option 1 then option 7 to enter the HCS and TxHmL Waiver Programs queue. The full number is 800-626-4117, Option 1, then Option 7.
Location Code Issue
Resolution: LIDDAs submitting Individual Plan of Care (IPC) transfers for clients were receiving incorrect location codes. This issue has been resolved. Providers that received an incorrect location code need to resubmit the IPC transfer.
See previous Volumes and info below:
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 4
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 3
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 2
HCS and TxHmL Waiver Programs: Trending Issue Support
Important Claims Submission Information for HCS and TxHmL Programs
LTC Online Portal Dashboard Accessibility Issue Resolved
IPC Forms 3608 and 8582 Issue Resolved
HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022
Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs
Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP
EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission
June 1st, 2002
Resolutions to the most frequently reported issues may be found at the following link for TMHP issues concerning entering IPC’s, dual entry into CARE, submitting claims, and more: “Trending Issue Support” Table
In addition, please see helpful links below including recent HCS/TxHmL FAQ’s in May of 2022.
View previous postings:
- Important Claims Submission Information for HCS and TxHmL Programs
- LTC Online Portal Dashboard Accessibility Issue Resolved
- IPC Forms 3608 and 8582 Issue Resolved
- HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022
- Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs
- Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP
- EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission
