Category: HHSC News

Failure to Submit Medical Records

ATTENTION COMMUNITY FIRST PROVIDERS Texas state regulations (Texas Administrative Code §353.502) require MCOs to conduct routine audits of Provider and Member claims to ensure that proper payments are made.   If you receive a request for medical records, return...

Update to COVID 19 Testing Billing

Following changes to the Clinical Laboratory Improvement Amendments (CLIA) regulations, CMS released updated guidance for COVID-19 test billing effective September 23, 2020.   Beginning January 3, 2022, HHSC is requiring providers to include modifier QW when...
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