---
title: HHAeXchange Texas Providers | Master Billing in HHAeXchange with 6 Essential Claim Submission Steps
description: Use the checklist below to ensure accurate billing submissions and avoid claim denials—allowing you to get paid on time and avoid additional work.
---
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TEXAS HOMECARE BILLING GUIDE
# 6 Essential Claim Submission Steps to Master Billing in HHAeXchange
Ready to start billing in HHAeXchange? Before you hit "submit", there are a few key steps you need to take for successful claim submission. Use the checklist below to ensure accurate billing submissions and avoid claim denials—allowing you to get paid on time and avoid additional work.
## Review EVV Aggregation Transaction Manager
- To streamline billing efficiency, it is crucial to take action in the EVV Transaction Manager. EVV Holds should be corrected and visits should be submitted to and accepted by the Aggregator before invoicing. The [EVV Transaction Manager Guide](https://hhaxsupport.s3.amazonaws.com/SupportDocs/EDI+Guides/EVV+Aggregation/TX/HHAX+EVV+Aggregation+Transaction+Manager+Rule+Holds_TX.pdf) outlines all holds and how to resolve them.
- If you have already invoiced, you will need to unbill the visit, edit the visit, and rebill. Refer to the [Unbilling](https://hhaxsupport.s3.amazonaws.com/SupportDocs/Enterprise/Enterprise%20Help%20Center/Enterprise%20Help%20Center%20TEXAS%20ENTF/Content/Billing/Unbilling.htm?Highlight=unbilling) and [Rebilling](https://hhaxsupport.s3.amazonaws.com/SupportDocs/Enterprise/Enterprise%20Help%20Center/Enterprise%20Help%20Center%20TEXAS%20ENTF/Content/ENTF/Billing/Rebilling%20(Resubmit%20Claims).htm) topics for details and instructions.
## Enter Diagnosis Codes (DX)
- Ensure Diagnosis Codes (DX) are added to the authorization. A Diagnosis Code is required to create a claim and successfully bill and is derived from ICD-10 diagnosis codes published by the Centers for Medicare & Medicaid Services (CMS).
- If DX Code is blank, the invoice is held under Billing Review until codes are added.
- To check or add codes, click on the *Auth/Orders* page in the Member Profile. Locate the authorization and click on the edit icon (). On the Edit Authorizations page, under the **Billing Diagnosis Codes** section, review the information or click on the **Add** button to enter a DX Code.
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- The *Add Diagnosis Code* pop-up window opens for you to enter or search and select the **ICD Codes**. Once a Dx Code is selected, mark the code as an **Admitting Diagnosis**or a **Primary Diagnosis.**
- Note: The system automatically selects the diagnosis code as Primary, if it is the only code assigned in the authorization.
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## Billing/Pay-to Provider (Taxonomy) Code Verification
- A **taxonomy code** is a unique 10-character code that designates the classification and specialization. Please use the taxonomy code that was selected during credentialing when enrolling with the payer. i.e. In Home Supportive Care: 253Z00000X.
- Check the e-billing configuration to verify that the correct Billing/Pay-to Provider (Taxonomy) code is correct.
- Go to ***Admin \> Payer Setup \> Search Payer*** to locate and select the Payer by clicking on the **Payer Name** link. On the Payer Setup page, go to the **Billing Collections**tab and click on the **E-billing Configuration** hyperlink at the top section of the page.
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- The **E-Billing Configuration** pop-up window opens. Scroll to **Segment ID PRV-03**, described as Billing/Pay-to Provider Specialty Information, and verify that the correct code is listed in the **Values** column. If the code needs to be added, corrected or updated, then please contact support via the [Client Support Portal](https://hhaxsupport.atlassian.net/servicedesk/customer/portals).
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## Authorization Review
- Confirm that the **Budget Number** or **Referral Number** matches your intended submission.
- The Budget Number applies only to Long-Term Care (LTC) family care, with values of 1 to 5, as assigned by the Payer.
- If applicable, the Budget Number is seen in the visit **Schedule**tab or in the Master Week, available to edit. On the visit *Schedule* tab, the **Budget Number** field is seen on the right of the **Duration** field.
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- To edit on the **Master Week**, locate the applicable Master Week and click on the edit icon to open the *Master Week* page. The **Budget Number** field(s) displays under the **Service Code(s)** field, per day.
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- Other programs may use a **Referral Number** or an **Authorization Number**. To verify this information, go to the Patient Profile, *Auth/Orders* page. This is the number loaded and displayed in the **Authorization #** field.
- If incorrect, then update the field ***BEFORE*** invoicing.
- If rejected, then unbill the visit, update the authorization, and rebill. Refer to the [Unbilling](https://hhaxsupport.s3.amazonaws.com/SupportDocs/Enterprise/Enterprise%20Help%20Center/Enterprise%20Help%20Center%20TEXAS%20ENTF/Content/Billing/Unbilling.htm?Highlight=unbilling) and [Rebilling](https://hhaxsupport.s3.amazonaws.com/SupportDocs/Enterprise/Enterprise%20Help%20Center/Enterprise%20Help%20Center%20TEXAS%20ENTF/Content/ENTF/Billing/Rebilling%20(Resubmit%20Claims).htm) topics for details and instructions.
## Verify Modifiers on Service Codes (HCPCS)
- In some cases, a modifier must be added post-invoicing. These modifiers are an extension of the existing Service Codes (HCPCS), identified as two characters following the Service Code (HCPCS), divided by a colon. These codes can be updated in the visit Schedule tab or in the Master Week page.
- From the **Service Code** field, select the applicable value with modifier from the dropdown. Ensure to first unbill the visit and then update the Service Code.
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- If the required modifier is not available in the list of values, then submit a request to our team via the [Client Support Portal](https://hhaxsupport.atlassian.net/servicedesk/customer/portals).
## Check Plan Codes Rates
- If Billing Rates are showing as $0.00 when invoicing, then the **Plan Code** rates must be entered for that contract.
- Go to ***Admin \> Payer Setup \> Search Payer*** to locate and select the Payer. Click on the **Payer Name** link to open the *Payer Setup* page. Select the *Billing Rates* tab and click on the edit icon for the Service Code to edit. (DO NOT use the ***Update Rate*** button!)
- On the *Payer Rate* window, enter the applicable codes in each **Plan Code** field as required by the system (required fields are denoted by a red asterisk).
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- If the agency does not know the Plan Code rate, then check the rates on the Texas Medicaid Healthcare Partnership (TMHP) website, reach out to the Payer, or enter the main rate amount for each Plan Code.
- Loaded **Plan Codes** display on the *Payer Placements* section of the Member’s *Payers* page.
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## Claim Status Check
- Please allow approximately 48 hours to see the status in HHAX or TMHP.
- You can complete a claim status inquiry in TexMedConnect to check the status of a claim. Visit the [TMHP TexMedConnect resource page](https://www.tmhp.com/resources/texmedconnect) for more information.
- Run the Claims Status Report (Report \> Billing \> Claims Status).
- If the status is *rejected*, then the reason(s) for rejection are listed under the Claim Status Reason column.
- If the status is not available after 48 hours, then submit a ticket via the [Client Support Portal](https://hhaxsupport.atlassian.net/servicedesk/customer/portals) with the subject line "TX Status Not Found."
## Still need help with billing?
Check out our [Billing Review Training Video](https://hhaxsupport.s3.amazonaws.com/SupportDocs/ENTF/TX/TX-11+Billing+Review-082223.mp4), [Interactive Billing Training](https://demo-teamwalnut.hhaexchange.com/player/?demoId=9f8d5f2c-b3bf-4e06-bec8-433974b0a816&showGuide=true&showGuidesToolbar=true&showHotspots=true&source=app), or get details on how you can [Talk to a Trainer](https://www.hhaexchange.com/info-hub/texas#open-hours-talk-to-a-trainer).
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