05-13-15 Nursing Facility Services Transitioning To STARPLUS PDF
05-13-15 Nursing Facility Services Transitioning To STARPLUS PDF
05-13-15 Nursing Facility Services Transitioning To STARPLUS PDF
When billing for managed care claims with consecutive service dates without a
change in the level of service or gap in service dates, providers must enter these
claim transactions as one line item on the Details tab in TexMedConnect. (See
examples below)
Note: Entering multiple rows for consecutive service dates can result in an initial
claim denial by the managed care organization (MCO) during processing.
For claim transactions which include a gap in the dates of service and/or a
change in the level of service, separate claims should be submitted to avoid
potential processing problems.
Providers can submit claims with multiple lines through the MCO provider portal at:
o Amerigroup: https://providers.amerigroup.com/pages/tx-2012.aspx
o Cigna-HealthSpring: https://starplus.hsconnectonline.com/login.aspx
1 of 2
o Molina: www.molinahealthcare.com/providers/tx/medicaid/Pages/home.aspx
o Superior: www.superiorhealthplan.com/for-providers/secure-web-portal/
o United Healthcare: www.unitedhealthcareonline.com
For questions related to MCO Portal submission contact the appropriate MCO Provider
Service Representative:
2 of 2