Effective April 1, 2022, we’re changing the way we process claims for STAR Kids (Medicaid) members with Medicare benefits in Texas.
Please review the claims submission process below to ensure accurate claims processing and prevent future claim denials. Please note that the process for billing members with commercial coverage as primary is not affected by these changes.
How to bill and avoid claim denials:
When and how to submit an appeal
If you submit a secondary claim to UnitedHealthcare, are denied and believe UnitedHealthcare is the proper secondary payor, you can appeal.
For information about filing an appeal, go to UHCprovider.com/TXcommunityplan > Care Provider Manuals > Texas > UnitedHealthcare Community Plan of Texas STAR Kids Administrative Guide / Care Provider Manual.
Texas Medicaid Provider Procedures Manual: Go to tmhp.com > Medicaid Provider Manual > Texas Medicaid Provider Procedures Manual.
For help submitting claims to TMHP: Go to tmhp.com > Medicaid Provider Manual > Texas Medicaid Provider Procedures Manual > Individual Chapters PDF > Volume 1, Section 6: Claims Filing. You can also call the TMHP Contact Center General Inquiries Line at 800-925- 9126.
Please call Customer Service at 888-887-9003, 8 a.m.–6 p.m. CT, Monday– Friday.