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On-Line Medicaid Billing-Nursing Home

Access the Texas Medicaid website, www.tmhp.com to bill Nursing Home claims. Select Providers link (top of screen) and then select Access TexMedConnect (right side of screen).

1. Medicaid a. If pt is utilizing hospice services and has Medicaid, we have to bill and pay for their room and board b. You will receive an email with new admitted patient information from each location c. The nursing home bills a patients private insurances for services d. only bills Medicare for hospice skilled services and Medicaid for Room and Board e. Drew and Troy took over Nursing home billing in July f. A folder for each location is called Medicaid, each office has its own folder, each office folder has a spreadsheet for each Nursing home i. There is also a spreadsheet for Medicaid Primary g. Medicaid hospice pays for different levels of rooms at different rates i. Tile or RUG rates: ranges from $100 to $250 a day depending on the level of care h. There are 25 levels of facilities (25 being the low end facility) i. deals with level 5-12 facilities i. Ex: tile level CA2 = $114 (refer to cross legend) j. Texas Medicaid Website is: www.tmhp.com – Below are features of the site i. MESAVE lets you check patient eligibility ii. Look for NURSING FACILIITY ROOM AND BOARD iii. NEED TO RECERTIFY PATIENTS EVERY 6 MONTHS (form 3074) 1. I will fill out and have the doctor sign the form 2. Form 3071 is an election form 3. Form 3074 which is the recert election form a. Must be signed by attending and hospice physician b. Can download and upload these forms to

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