Monthly Archives - September 2020

Provider Alert!

Provider Alert! Invoices Required for Manually Priced Laboratory Testing Claims Submissions

table { border-collapse: collapse; }tr,td { border: solid thin; } Attention: Laboratory Providers Effective Date: September 21, 2020 Providers should monitor the Texas Children’s Health Plan (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: Laboratory providers submitting claims for COVID-19 testing or other services for a manually priced test must include the appropriate [...]

Provider Alert!

Provider Alert! Limit increased for Code A4628, Oral Suction Catheter

Attention: All Providers Effective Date: September 22, 2020 Providers should monitor the Texas Children’s Health Plan (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: Texas Children’s Health Plan (TCHP) would like to inform providers that effective September 22, 2020 the limit for HCPCS Code A4628, oral suction catheter has been increased from [...]

Provider Alert!

Provider Alert! Prior Authorization Update for Botulinum Toxin Benefits with Diagnosis Restriction

  Date: May 20, 2021 Attention: All Providers   Effective Date: May 18, 2021 Providers should monitor the Texas Children’s Health Plan (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: Texas Children’s Health Plan (TCHP) would like to remind providers of the prior authorization requirements for Botulinum Toxin effective October 1, 2020. A prior [...]

Provider Alert!

Provider Alert! Texas Medicaid and CHIP Immunization Alert – Vaccines for Specific Ages

table { border-collapse: collapse; }tr,td { border: solid thin; } Date: September 29, 2020 Attention: All Providers Providers should monitor the Texas Children’s Health Plan (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: The Center for Disease Control and Prevention (CDC) recommends the following vaccines for children and adolescents.  Please refer to [...]

Provider Alert!

Provider Alert! Prior Authorization Update for HCPCS Code H2011, Crisis Intervention

Attention: Behavioral Health Providers Effective Date: September 22, 2020 Providers should monitor the Texas Children’s Health Plan (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: Texas Children’s Health Plan (TCHP) aligns with the prior authorization guidance available in the Texas Medicaid Provider Procedures Manual (TMPPM) for HCPCS Code H2011 Crisis Intervention, per [...]

Provider Alert!

Provider Alert! Healthy Rewards/Value Added Services for 2020-2021

table { border-collapse: collapse; }tr,td { border: solid thin; } Attention: All Providers Effective Date: September 1, 2020 through August 31, 2021 Providers should monitor the Texas Children’s Health Plan (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: Texas Children’s health Plan (TCHP) is proud to present our Extra benefits/Value Added Services [...]

Provider Alert!

Provider Alert! Update: Substance Use Disorder (SUD) Service Code H0050 now requires a Prior Authorization and Authorization Reminders

Attention: Behavioral Health Providers    Effective Date: September 23, 2020 for Code H0050 Providers should monitor the Texas Children’s Health Plan (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: Texas Children’s Health Plan (TCHP) aligns with the prior authorization criteria available in the most recent Texas Medicaid Provider Procedures Manual (TMPPM), Withdrawal Management [...]

Provider Alert!

Provider Alert! Attention: NCQA HEDIS Measure Changes

Attention: PCP, OB/GYN and Endocrinologist Providers Effective Date: January 1, 2020 Call to action: Texas Children’s Health Plan (TCHP) would like to inform you of changes to the National Committee for Quality Assurance (NCQA) HEDIS Technical Specifications released on July 1st, 2020. How this impacts providers: These changes are effective as of January 1, 2020. Please submit all claims timely, as soon as services are rendered, and use appropriate codes to reflect the services provided particularly for Well-Care Visits and THSteps. REVISED MEASURES Well-Child Visits [...]

HEDIS Toolkit Offers Benefits to Providers

Members are cared for as HEDIS measures are met  Texas Children’s Health Plan developed a HEDIS Toolkit that contains helpful information regarding the measure requirements, standards and codes to use that are acceptable for HEDIS reporting. The new toolkit can be accessed here. This toolkit will serve as a reference form that can be used to code the type of appointments made and ensure that all of the HEDIS standards are met.  This will help providers maintain high quality care and [...]

Provider Alert!

Provider Alert! Screening and Coding for Social Determinants of Health

table { border-collapse: collapse; }tr,td { border: solid thin; } Attention: Primary Care and Obstetric Care Providers Providers should monitor the Texas Children’s Health Plan (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 stewards of our member’s care, Texas Children’s Health Plan (TCHP) would like to raise your awareness of [...]