Appeals Process By Payer and Template Letters - information regarding appeal and dispute processes for the various major commercial payers, as well as template appeal letters.
Complaints - information on how to file a payer complaints.
Compliance Posters - links to the posters and notices that should be posted in the office.
Concealed or Open Carry Handguns on Private Property - TMA white paper regarding Prohibiting Concealed or Open Carry Handguns on Private Property.
Credentialing - Texas Expedited Credentialing - information regarding expedited credentialing for groups.
Employee Retirement Income Security Act (ERISA) - information on the claims dispute process for self insured plans.
EMS Patient Transportation Rules - information for patients regarding Houston's EMS Transportation rules.
Forms and Posters - link to our Helpful Grids page for forms, templates, posters, and other resources.
Hearing Impaired Patients - information regarding rules and guidance on interpreters and treating hearing impaired patients, and those with limited-English proficiency (LEP).
Leaving a Group Practice - information regarding rules and guidance when leaving a group practice.
Medical Records - information on medical records rules and regulations regarding.
Narrow Networks Complaints - TMA has drafted a letter template for patients to use to file a complaint with the Texas Department of Insurance (TDI) regarding network inadequacy.
Out of Network Disclosure Forms - links to the the major payers "Out-of-Network Disclosure" forms. Participating physicians are required to have these forms completed prior to referring the patient to an out-of-network facility or physician.
Physician Extenders - information regarding the billing guidelines for physician extenders.
Practice and Payment Models - information on various Practice and Payment Models (ACO, Bundled Payment, Cash Practices, etc.).
Recoupments - information regarding recoupment rules and regulations.
Reputation Management - information and resources on preventing and repairing negative online ratings and establishing a positive online presence.
Starting Your Own Practice - a new practice checklist that is designed to help physicians starting their own practice.
Selling or Closing Your Practice - information regarding rules, guidance and resources when retiring, closing, or selling a practice.
Telehealth - information and rules regarding telehealth, as well as a link to HCMS' Telehealth Grid with payer policies and reimbursement information.
Texas Medical Board (TMB) - information on Board rules, licensure, the complaint process, electronic death registration, the Prescription Monitoring Program, etc.
Tort Reform Patient Agreement - Template agreement for out-of-state patients stating they agree that their medical care provided in Texas will be governed by Texas law.
501(a) Health Care Organizations - information regarding 501(a) organization definitions, certifications, local organizations, and how to file a complaint.