Fannin County Indigent Health Care Program
1203 E. Sam Rayburn Drive, Suite 113
Bonham, Texas 75418
1) All claims must be on a CMS-1500 or UB-04.
2) When sending a UB-04, an itemized statement must be attached.
3) Claims must be received within 95 days from the date of service.
Prior Authorization Of Services:
All providers must notify the Fannin County Indigent Health Care Program of any inpatient or outpatient admissions and prior to any surgeries, procedures or imaging. Failure to do so may delay or prevent claims processing and payment.
Allowable Healthcare Expenses:
1) Family Practice / Specialist Office Visits - In Office Procedures
2) Inpatient / Outpatient Hospital Visits
3) Lab - Radiology - Diagnostic Testing
4) Well Visits - Screenings - Immunizations
5) Prescriptions - Diabetic Supplies
6) Outpatient Physical Therapy