Provider Alerts! Prior Authorization Updates

Provider Alert!

Provider Alerts! Prior Authorization Updates

Date: November 7, 2022

Attention: All Providers              

Effective date: September 1, 2022

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 of updates to the prior authorization lists.

How this impacts providers: The updates are as follows:

  • Effective August 22, 2022: Targeted Case Management and Mental Health Rehabilitation Services no longer requires prior authorization
  • Effective September 1,2022: Case Management for Children and Pregnant Women carve-in requires a prior authorization

Next steps for providers: Providers should become familiar with the prior authorization guidelines and check them regularly for further updates.

Click here for Prior Authorization Requirements

Links to provider alerts previously posted:

Targeted Case Management and Mental Health Rehabilitation Services: http://www.thecheckup.org/2022/08/31/provider-alert-prior-authorization-is-no-longer-required-for-mental-health-targeted-case-management-and-mental-health-rehabilitative-services/

Case Management for Children and Pregnant Women carve-in: http://www.thecheckup.org/2022/10/06/provider-alert-case-management-for-children-and-pregnant-women-cpw-carve-in-4/

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.

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