Member Services 1-877-901-7321, TDD/TTY: ... • Effective Date — The date the member’s Texas Medicaid Dental Services coverage started. 2, … Our contract with the Texas Health and Human Services Commission (HHSC) has the complete information. You have the right to get this Handbook in: • Audio • Braille Medicare-Medicaid Plan 2020 | Member Handbook. As people age, they may require long-term care services to protect their health and improve their wellbeing. Attention: All Providers Effective Date: July 1, 2020 Updated September 10, 2020 Call to action: Texas Children’s Health Plan (TCHP) aligns with the Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations that are implemented for claims processing by TMHP for Texas Medicaid. The fee displayed is the allowable rate for this service. ... of Texas STAR Kids Member Handbook 2020-2021 Aetna Better Health of Texas covers members in the Dallas Service Area in the following counties: Dallas, Collin, Rockwall, Hunt, Kaufman, Ellis and Navarro Counties. Member Handbook 2020. The COB/TPL Handbook was completed by the COB/TPL Team in the Division of Health Homes, PACE, and COB/TPL (DHPC), Disabled and Elderly Health Programs Group (DEHPG), Center for Updates to the Texas Medicaid Provider Procedures Manual tcph 2020-07-30T15:45:42+00:00 By tcph Primary Care Providers , Office Managers , Provider Alert medicaid 0 … 2020-2021 STAR Kids (Medicaid) Member Handbook Dallas and Tarrant service areas . Medicaid is a wide-ranging, jointly funded state and federal health care program for low-income individuals of all ages. • Other important information on Texas Medicaid Dental Services. Medicaid is the State of Texas Access Reform (STAR) Managed Care Program (Medicaid). Giving Advice, B-2600 Medicaid Estate Recovery Program Notification Requirements, B-2610 Types of MEPD Groups Subject to MERP, B-2620 HHSC MERP Notification Requirements, B-3210 Who May Complete an Application for Assistance, B-3220 Who May Sign an Application for Assistance, B-6100 Face-to-Face and Telephone Interviews, B-6510 Failure to Provide Missing Information, B-7200 SSI Cash Benefits Denied Due to Entry into a Medicaid Facility, B-7210 Ensuring Continuous Medicaid Coverage, B-7300 MEPD Eligibility Pending a Decision of SSI Application, B-7400 Application for Institutional Care, B-7431 Denial of Level of Care/Medical Necessity Determination, B-7450 Medicaid Certified Person Enters Nursing Facility or Home and Community-Based Services Waiver Program, B-8100 Certificates of Insurance Coverage, B-8300 Who May Sign a Redetermination Form, B-8400 Procedures for Redetermining Eligibility, B-8420 Notification of Changes as a Result of Redetermination, B-8440 Streamlined Redetermination (Passive Redetermination), B-8450 Special Reviews when Facility Contract Closure or Cancellation Occurs, B-9200 Medical Necessity/Level of Care Determination at Redetermination, B-9300 Date of Death Denials and Verification Sources, C-2000 Confidential Nature of the Case Record, C-2600 Procedure for Preventing Disclosures of Information, C-3000 When and What Information May Be Disclosed, C-4000 Confidential Nature of Medical Information, C-6110 Program Representation at Fair Hearings, C-6200 Applicant/Recipient and Provider Fraud Detection and Referral, C-7000 National Voter Registration Act of 1993, C-8000 Responsibility to Provide Information and Report Changes, C-9000 Interpreter and Translation Services, C-9100 Requirement for Interpreter and Translation Services, C-9200 Availability of Translated Written Material, D-1100 Related Texas Administrative Code Rules, D-2000 Determining Blindness or Disability, D-2100 When a Medical Determination Is Not Required, D-2200 When a Medical Determination Is Required, D-2300 Requesting a Decision from the Disability Determination Unit (DDU), D-2400 Disability Determination Unit (DDU) Request Required, D-2500 Supplemental Security Income (SSI) Applicants and Retroactive Coverage, D-2600 Disability Determination Unit (DDU) Decision, D-2700 Use of Decision on the Disability Determination - DDU Page in TIERS, D-2800 Disability Determination at Time of Review, D-3100 Related Texas Administrative Code Rules, D-3610 Interstate Requests for Assistance, D-3620 Out-of-State Medicaid and Texas Medicaid Recipients, D-3630 Texas Applicant Outside the State of Texas, D-3650 Out-of-State Recipient Visiting Texas, D-4000 Fiduciary Agents and Living Arrangement, D-5220 Compact of Free Association States, D-5300 Acceptable Documentation of Citizenship and Identity, D-5310 Exceptions to Documentation of Citizenship and Identity Requirement, D-5320 Using Wire Third-Party Query (WTPY) to Verify Citizenship, D-5510 Initial Request at Time of Application, D-5520 Initial Request at Time of Redetermination, D-6000 Social Security Number (SSN) and Application for Other Benefits, D-6210 When a Person Does Not Have an SSN, D-6300 Application for Other Benefits Requirement, D-6310 Other Benefits Subject to Application Requirement, D-6320 Other Benefits Exempt from Application Requirement, D-6330 Payments That Are Not Other Benefits, D-6340 Supplemental Security Income (SSI), D-6354 Requirement to Apply for Apportionment of Augmented VA Benefit, D-6420 Payment Options for Other Benefits, D-6421 Survivor's Benefits for Spouses and Other Dependents, D-6422 Other Benefit Lump Sum or Annuity Exception, D-6440 Establishing Eligibility after Denial, D-6500 Exceptions to the Application for Other Benefits Requirement, D-6600 When Not to Refer for Other Benefits, D-7200 Cooperation and Assignment of Rights for Medicaid Eligibility, D-7300 Potential Sources of Third-Party Coverage, D-7500 Third-Party Resources for SSI Recipients, D-7510 Social Security Administration (SSA) Role and Supplemental Security Income (SSI) Recipients, D-7700 Health Insurance Premium Payment Reimbursement Program, D-8310 Qualified Aliens Subject to a Seven-Year Limited Period, D-8320 Qualified Aliens Not Subject to a Waiting Period or Limited Period, D-8330 Qualified Aliens with a Five-Year Waiting Period, D-8340 Establishing Qualifying Quarters of Social Security Coverage, D-8341 Combining Qualifying Quarters of Spouse/Parent, D-8342 Qualifying Quarters Earned on or After Jan. 1, 1997, D-8344 Procedures for Verifying 40 Quarters, D-8410 Veterans, Armed Forces Active Duty and Dependents, D-8411 Loss of “Veteran/Active Duty” Status. You can get this handbook in larger print, audio (CD), braille, or in any other language format, if needed. Nursing homes, in-home health care, and assisted living facilities are the most common long-term care services for seniors, however theyre also the most expensive. This manual is a comprehensive guide for Texas Medicaid providers. We will send you a copy free of charge. It covers extra services and drugs not covered by Medicare. Most Medicaid plans in the state of Texas are provided by Managed Care Organizations (MCOs). Your Texas Benefits Medicaid Card 1-855-827-3748 or 2-1-1 *TTY lines are only for members with hearing or speech loss. 01/01/2020 – 12/31/2020 . �H�:�^���s�����h� �{�I* +d�]�"�[��; Texas H8197-001 . According to Genworth Financial, the average annual cost of long-term care in Texas is between $42,000 - $72,635, and for many seniors, these high costs can be a hindrance to retirement. * Adobe Reader may be required to view the file. If you need a sign language interpreter, please call <> ... Texas Medicaid is a program run by the federal government and the state that helps people with 1. In Medicaid 2020. 2 . %���� SHARS allow local school districts, including public charter schools, to obtain Medicaid reimbursement for certain health-related services documented in a student's Individualized Education Program (IEP). Serving Bexar, Dallas, El Paso, Harris, and Hidalgo Counties. 2020 HCPCS Updates for Texas Medicaid SHARS Program – Counseling and Psychological Services Information posted January 23, 2020 . Provider reimbursement for telemedicine services must be at the same rate as Medicaid reimburses for the same in-person medical service. What if I need help with the member handbook? See page 16 for additional information. MCNA is the largest dental insurer in the nation for state-sponsored Medicaid and CHIP programs. H8197_20_17208_001_TXMMPMbrHbk Accepted 9/20/2019 Molina Dual Options STAR+PLUS Medicare-Medicaid Plan . stream How this impacts providers: Second Quarter 2020 HCPCS Added … Chapter A, General Information and MEPD Groups Section A-1000 General Information A-1000 General Information A-1100 Texas Administrative Code Rules Section A-2000 Mandatory Coverage Groups A-2000 Medicaid for the Elderly and People with Disabilities Handbook | Texas Health and Human Services Section 2: Find Out if Medicare Covers Your Test, Service, Or Item - Pages 25-28 [MP3, 2.09 MB] We will give you a copy of the contract on request. If you need help to understand the member handbook, call FirstCare CHIP or CHIP Perinatal Customer Service at 1-877-639-2447. To use a general fee schedule, Medicaid providers can click Static Fee Schedules. Texas Medicaid Provider Handbook Supplement 6—© 2006-2020 Magellan Health, Inc. (Rev. 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