Monthly Archives - January 2016

Provider Alert! Authorization requirement for non-emergent ambulance transfer

To: All providers Subject: Authorization requirement for non-emergent ambulance transfer Effective: April 1, 2016 Texas Children’s Health Plan members who require the use of an ambulance for non-emergent transport must have the request for authorization submitted by the member’s physician, facility or health-care provider. The request will be reviewed to determine if alternate means of transportation can be utilized for transport to a scheduled medical appointment or to and from a treating facility. Texas Children’s Health Plan does not accept authorization requests from [...]

Provider Alert! Annual Reminder on Copayments and Deductibles

To:  All Texas Children’s Health Plan Providers Subject: Annual Reminder on Copayments and Deductibles Texas Children’s Health Plan will pay for a primary insurance deductible with proof of assignment to the deductible on the primary evidence of procedure. Payments will be made up to Medicaid allowable only. Claims for primary insurance copayments should be sent to Texas Medicaid and Healthcare Partnership directly.  Texas Children’s Health Plan will not pay CP001 or CP002 on a claim as these are not payable by the [...]