February 19, 2026
Quick recap
The meeting focused on billing and insurance challenges faced by behavioral health organizations, particularly regarding Medicaid, Medicare, and private insurance claims. Participants discussed issues with Texas Children's Hospital and other providers regarding denial codes, particularly the H0005 billing code, and difficulties in reaching dedicated insurance representatives for claims resolution. The group explored how software updates and AI automation are increasingly affecting claims processing, leading to unexpected denials and payment issues. They also discussed concerns about high insurance deductibles and coinsurance fees preventing patients from accessing necessary treatment, with participants agreeing to raise these issues at the next HHSC meeting. The conversation concluded with a discussion about tracking administrative time spent on billing activities, which could help demonstrate the operational costs associated with insurance claims processing.