Attention: Early Childhood Intervention (ECI) Providers

Attention: Early Childhood Intervention (ECI) ProvidersEffective Date: April 3, 2020 Call to action: In accordance with guidance from Texas Medicaid Provider Procedures Manual (TMPPM), providers must use the associated benefit code when submitting claims. How this impacts providers: Changes in billing practices may be required if there are claim denials. Next steps for providers: Billing reminders:

• Providers should ensure that their claims submissions include their benefit code per TMHP guidelines.
• If the taxonomy code is attested to a benefit code, the benefit code should be entered in SBR03 on an electronic claim and in 11c on a paper claim.
• On the 837, the field for the benefit code is SBR03 (this information is showing in both the TCHP and TMHP 837 Companion Guides) and on a paper claim, the correct field is 11c (showing Section 8.5.4 CMS-1500 Instruction Table of TMPPM Section 6:  Claims Filing).

Resources:TMPPM ECI ServicesTCHP companion guideTMHP 837 companion guideTMPPM section 6: claims filingIf you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers