SECTION 71.205. Release for Eligibility Verification, Billing, and Service Delivery

(a) Medicaid providers. A Medicaid provider or its authorized representative may get client information for eligibility verification and billing purposes. An authorized representative must have an agency agreement on file with DHS to get information on behalf of a Medicaid provider.

(1) For electronically stored information, a Medicaid provider or its authorized representative must contact its Medicaid claims administrator representative.

(2) For other forms of information, a Medicaid provider or its authorized representative must contact DHS and supply its Medicaid provider number.

(b) Non-Medicaid providers. A provider of services, other than Medicaid services, to DHS clients may get client information for eligibility verification and service delivery purposes. To get client information, a provider must contact its DHS contract manager.

(c) Other government agencies. Local, state, and federal government agencies may get client information for purposes of administering welfare or assistance programs as provided by state and federal law. To get client information, a local, state, or federal government agency must contact its DHS liaison.

Source Note: The provisions of this §71.205 adopted to be effective April 14, 2003, 28 TexReg 2356