Managed Care Payor Resource Page
Commissioner Bulletins
- Commissioner´s Bulletin NO. B-0008-05 (February 2005)
- Commissioner´s Bulletin NO. B-0017-04
- Commissioner´s Bulletin NO. B-0004-04 (January 2004) | MS Word
- Commissioner´s Bulletin NO. B-0042-03 (October 2003)
- Commissioner´s Bulletin NO. B-0041-03 (October 2003)
- Commissioner´s Bulletin No. B-0012-02 (April 2002)
- Commissioner´s Bulletin NO. B-0023-01 (May 2001)
Rules
- SB 418 Adopted Rules on Batch Rejection, Annual Verification Reporting Date, Underpayment Penalty Calculation, Preauthorization and Verification Availability for Dental and Vision HMOs, and Eligibility Information
- SB 418 - Submission of Clean Claims Proposed Rules Summary (October 2003)
- Submission of Clean Claims/Waiver of Electronic Filing Requirements (April 2004)
- Submission of Clean Claims/Reporting Requirements for Pharmacy Claims (April 2004)
- Submission of Clean Claims/Identification (ID)Cards
- Submission of Clean Claims/Required Data Elements/Dental
- Submission of Clean Claims/Waiver of Statutory Provisions
- SB 418 - Prompt Payment of Health Care Claims Emergency Rules Summary (August 2003)
- SB 418 - Prompt Payment of Health Care Claims Proposed Rules Summary (June 2003)
- HB 610 - Prompt Payment of Health Care Claims Rules (September 2001)
- HB 610 - Prompt Payment of Health Care Claims Rules (May 2000)
Technical Advisory Committee
Education
- "Finding Your Way to Prompt Pay" (MS PowerPoint slide show) | zip | pdf
- Self Funded ERISA vs. Fully funded Identification on cards | MS Word (zipped) | pdf
- Submission, Timelines and Prompt Pay of Clean Claims (SB 418 and HB 610 comparison) | MS Word (zipped) | pdf
- Provider Contracting Requirements | MS Word (zipped) | pdf
- Verification and Preauthorization Procedures | MS Word (zipped) | pdf
- Verification Requirements | MS Word (zipped) | pdf
- CMS 1500 - Texas Clean Claims Elements | MS Word (zipped) | pdf
- UB 04 - Texas Clean Claims Elements | MS Word (zipped) | pdf
- SB 418 Provisions for HMOs | MS Word (zipped) | pdf
- SB 418 Provisions for PPOs | MS Word (zipped) | pdf
- SB 418 FAQs
- HB 610 Prompt Pay FAQs
- HB 610 Claims Payment FAQs
Enforcement
- April 29, 2002 Restitution/Fines (as of July 2002)
- April 1, 2002 Restitution/Fines (as of June 2002)
- January 2002 Restitution Summary
- Life, Health and Licensing 2002 Compliance Workshop Introduction
For more payor information, click on the links below:
- Life, Health and Licensing 2004 Compliance Workshop
- Life, Health and Licensing 2002 Compliance Workshop
- Commissioner´s Bulletin NO. B-0012-02
- Submission of Clean Claims Rules
- Commissioner´s Bulletin NO. B-0023-01
For more information contact:
Last updated: 01/26/2010
