Medicare-Adjusted Crossover Claims to Be Reprocessed

TMHP has identified an issue that impacts Medicare crossover claims coinsurance and deductible reimbursement for services that are rendered to Medicaid dual-eligible clients.

Medicare-adjusted crossover claims that were previously paid by Texas Medicaid with a paid date of July 22, 2011, may have been denied and recouped in error.  Then these claims are reprocessed, providers may receive additional payment, which will be reflected on future Remittance and Status Reports.

For more information, call the TMHP Contact Center at 1-800-925-9126.