Monthly Archives - March 2020

Provider Alert! UPDATE ALERT #3 –Telehealth Services – PT/OT/ST; FQHC/RHC Providers and COVID-19

Attention: All Providers Effective Date: March 31, 2020 Providers should monitor the Texas Children’s Health Plan Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Call to action: Texas Children’s Health Plan (TCHP) supports the delivery of telehealth (non-physician-delivered) distant site services to its members, and we have implemented special waiver provisions for its use during this [...]

Provider Alert! Select an EVV Vendor System or EVV Proprietary System Update

Attention: Financial Management Services Agencies (FMSA) Effective Date: May 1, 2020 Due to impacts of coronavirus, HHSC is extending the deadline to May to select an EVV system and begin the onboarding process. The original deadline was April 1,2020. Therefore, Financial Management Services Agencies (FMSAs) must select an Electronic Visit Verification or EVV Vendor System or EVV Proprietary System by May 1, 2020. How this impacts providers: All FMSAs currently contracted with MCOs or the Texas Health and Human Services Commission (HHSC).   Next steps [...]

Provider Alert!

Provider Alert! Reminder of mailing address and procedure for overpayments

Attention: All Providers Effective Date: March 20, 2020 Should a provider receive an overpayment from Texas Children’s Health Plan they should immediately take the following action. A provider has an obligation to notify Texas Children’s Health Plan in writing upon identification of an overpayment, no more than thirty (30) days from the date of discovery. The overpayment can be remediated through refund to Texas Children’s Health Plan, or a provider may request a recoupment from future claim payments.   For refunds: If a provider [...]

Provider Alert!

Provider Alert! New “Black Box” warning for Singulair (montelukast) and generic formulations

Attention: PCPs, Pulmonologists, and Pharmacists Effective Date: March 20, 2020 After careful analysis of the benefits and risks, the Food and Drug Administration (FDA) has strengthened the existing warnings on potential side effects on all Singulair and generic montelukast formulations. A “Black Box” warning has been included to stress the potential for serious side effects, including but not limited to serious behavior and mood-related changes. The FDA has also advised restricting the use for allergic rhinitis (hay fever) to those not [...]

Provider Alert! COVID-19 Disaster Declaration – Texas Children’s Health Plan Operational Adjustments

Attention: All Providers Effective Date: March 13, 2020 TCHP affiliated providers should monitor the TCHP Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.   Call to action: Reporting adjustments to normal provider business operations Texas Children’s Health Plan has developed a provider notification survey which is posted on the Provider portal www.texaschildrenshealthplan.org/for-providers and the website. This survey allows providers [...]

Provider Alert! COVID-19 Disaster Declaration – Prior Authorization Adjustments

Attention: All Providers Effective Date: March 18, 2020 TCHP affiliated providers should monitor the TCHP Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.   Call to action: As are result of the COVID-19 Disaster Declaration, TCHP has instituted the following:   In order to increase access to primary care services, TCHP is now waiving prior authorization requirements for out-of-network primary [...]

Provider Alert! Update – Telemedicine & Telehealth Services and COVID-19

Attention: All Providers Effective Date: March 17, 2020 Texas Children’s Health Plan supports the delivery of telemedicine and telehealth services to its members. As part of our COVID-19 Emergency Response, Texas Children’s Health Plan will add coverage of telemedicine services that are provided through only synchronous audio interactions (audio-only telephone consultation). How this impacts providers: Telemedicine services should be provided in compliance with standards established by the respective licensing or certifying board of the professional providing the services. While telemedicine services do not [...]

Provider Alert! Coronavirus disease 2019 (COVID-19) and Pregnancy

The following provider guidance is provided as a Texas Children’s Health Plan (TCHP) educational communication only. As many of our network providers are affiliated with other institutions and organizations who also set policy and procedure, this communication is not intended to replace, overwrite, amend or append to another institution’s guidance, policy or procedure. TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Attention: OB/GYN Providers Effective March 18, [...]

Provider Alert! Reporting Provider Office Closures and Changes due to COVID-19

Attention: All Providers Effective March 17, 2020 Reporting Provider Office Closures and Changes due to COVID-19 The severity of the Coronavirus disease 2019 (COVID-19) may have affected your ability to operate during normal business hours. If your office has made any changes to the regular business operations or has closed entirely and unable to provide services to our members at this time, please complete an online questionnaire on our main website, https://www.texaschildrenshealthplan.org/for-providers. Be sure to include any changes to your office status and [...]