Monthly Archives - August 2019
21Aug

UPDATE: Provider Portal/Health Effectiveness Data and Information Set (HEDIS)

We are still working on this portion of the Provider Portal project to bring you accurate, timely data so you can best manage your patients’ health. Please check our Provider Portal homepage for updates. Contact your provider relations manager to obtain your current HEDIS performance. Their contact information is available on our website, texaschildrenshealthplan.org on the For Providers page titled Meet our Team. It is also available on the Provider Portal at healthtrioconnect.com

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15Aug

No-cost sports and school physicals for CHIP and Medicaid patients

It’s back-to-school season, which means your patients will need to complete their annual sports and school physicals. As a value added service through our Healthy Rewards Program, CHIP and STAR patients ages 5 to 19 years and STAR Kids patients under 21 years can receive a no-cost sports and school physical if they have completed a Texas Health Steps or well-child visit within the last 12 months. Providers will be reimbursed for the cost of the sports and school physical. For...

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13Aug

Prenatal and postpartum care: best practices and professional guidelines for CHIP providers

Texas Children’s Health Plan encourages providers to follow best practices and professional guidelines. To assist in this, refer to the following reminders about covered benefits under Children’s Health Insurance Program (CHIP) and CHIP-Perinatal (CHIP-P): Prenatal Care The Centers for Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG), and American Academy of Pediatrics (AAP) all concur that immunization against Tetanus, Diphtheria, and Acellular Pertussis (Tdap) protects the perinate from morbidity and mortality attributable to pertussis infection1. Based on this guidance, the...

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10Aug

Improving Access to SBIRT

Improving Access to Screening, Brief Intervention, and Referral to Treatment in Primary Care for Adolescents: A Resource Center From the Center for Health Care Strategies, Inc. (CHCS) Adolescence is often a period for risky behavior and experimentation with alcohol and drugs. An estimated 70 percent of high school students have tried alcohol and 49 percent of high school seniors have used an illegal drug at least once. As a population, adolescents are more vulnerable than adults are to addiction. Early identification of...

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07Aug

Appointment Availability Standards for Primary Care and OB

Appointment availability standards What are appointment availability standards? How do you as a provider with Texas Children’s Health Plan play a role? In 2015 Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines. AFTER HOURS: Primary Care Physicians who are accessible 24 hours a day, seven days...

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Provider Alert!
06Aug

Provider Alert! TMHP EVV Prospective Process

Attention: All TCHP STAR Kids LTSS Providers Requiring EVV Subject: TMHP EVV Prospective Process Effective Date:  Effective 9/01/2019, the Texas Health and Human Services Commission (HHSC) will implement their new EVV claims matching process. Claims with a date of service on 9/01/2019 or later will be required to be sent to the Texas Medicaid & Healthcare Partnership (TMHP) for claims matching. After this date, all claims submitted directly to Texas Children’s Health Plan with a date of service on 9/01/2019 or later...

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01Aug

Flu protection for two: the importance of the flu vaccine during pregnancy

Influenza vaccination is an essential element of pre-pregnancy, prenatal, and postpartum care because influenza can result in serious illness, including a higher chance of progressing to pneumonia, when it occurs during the antepartum or postpartum period. In addition to hospitalization, pregnant women with influenza are at increased risk of intensive care unit admission and adverse perinatal and neonatal outcomes. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and the American College of Obstetricians and Gynecologists recommend that...

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