This CBT discusses procedures and general guidelines for submitting paper claims. This CBT does not discuss electronic claim submission. Refer to the TexMedConnect for Acute Care Providers CBT for information regarding electronic claim submission.

Modules include:
· Paper Claim Forms Introduction
· Paper CMS - 1500 Claim Form
· Paper UB-04 CMS - 1450 Claim Form
· Paper ADA Dental Claim Form
· Paper 2017 Claim Form

Education materials in this CBT are accurate as of publishing date. It is your responsibility to regularly review the current TMPPM and CSHCN Services Program Provider Manual and all updated information as it is published on the TMHP website in web articles and banner messages.

Get Started

Paper Claim Forms Introduction

Paper CMS - 1500 Claim Form
Paper UB-04 CMS - 1450 Claim Form
Paper ADA Dental Claim Form
Paper 2017 Claim Form

Paper Claim Forms

Introduction
Optional

Paper Claim Forms Introduction

Claim Forms
Optional

Paper CMS - 1500 Claim Form

Paper UB-04 CMS - 1450 Claim Form

Paper ADA Dental Claim Form

Paper 2017 Claim Form

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