Claims Processing Issue for STAR Kids and STAR+PLUS Dual Eligible Medicare and Medicaid Clients
AI Summary
TMHP has identified a claims processing error affecting STAR Kids and STAR+PLUS Dual Eligible Medicare and Medicaid clients from June 9-December 27, 2025. Claims were incorrectly forwarded to MCOs instead of being processed as fee-for-service, and TMHP will automatically reprocess affected claims while waiving timely filing requirements for resubmissions until February 28, 2026.
Action Required
By February 28, 2026: Billing team must identify and resubmit any STAR Kids or STAR+PLUS Dual Eligible claims from June 9-December 27, 2025 that were incorrectly forwarded to MCOs instead of processed by TMHP. Monitor future R&S Reports for additional payments from automatically reprocessed claims. Contact TMHP at 800-925-9126 for questions about affected claims.
Plan Types
Medicaid
States
TX
Specialties
all-specialties