Monthly Archives - November 2023

Provider Alert!
29Nov

Provider Alert! Reminder: Discharge Authorizations Fax Line

Date: November 29, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that the Discharge Authorizations Fax Line is now live. The toll-free number is 866-839-9879. Providers should use this line to send in authorization requests for members who are hospitalized at the time of the request and services or equipment that are necessary for care of the member immediately after discharge. Requests unrelated to discharge needs should not be sent to this number. Discharge Authorizations...

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27Nov

Provider Alert! COVID-19 Vaccine Procedure Code 91304

Date: November 27, 2023 Attention: All Providers Effective for dates of service on or after October 3, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after October 3, 2023, in accordance with the U.S. Food and Drug Administration’s (FDA) amended emergency use authorization for the Novavax COVID-19 vaccine, vaccine procedure code 91304 is now a benefit of Medicaid and CHIP. How this impacts providers: COVID-19 vaccine procedure code 91304 is...

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Provider Alert!
21Nov

Provider Alert! Home Health Care Services (HHCS) Providers and FMSAs Must Submit EVV HHCS Claims to TMHP

Date: November 21, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Effective Date: December 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that the Home Health Care Services (HHCS) are found in the Programs, Services and Service Delivery Options Required to Use Electronic Visit Verification by Jan. 1, 2024 document.  The EVV HHCS Service Bill Codes Table is posted on the EVV 21st Century Cures Act web page in Excel and PDF formats.   Claims Submission On June 1, 2023, the Texas Medicaid & Healthcare Partnership...

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Provider Alert!
21Nov

Provider Alert! HHAeXchange Electronic Visit Verification (EVV) Training Resources Available

Date: November 21, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that they can attend HHAeXchange Open Hours webinar sessions to ask questions, see methods demonstrated, or schedule a one-on-one session for additional help and training. Open Hours Webinar Sessions: The webinar sessions will be available Monday through Friday until Dec. 1 and do not require registration, so attendees can drop in and out between the selected hours. Program providers...

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Provider Alert!
20Nov

Provider Alert! Prior Authorization Signature Requirements

Date: November 20, 2023 Attention: All Providers Effective Date: December 20, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that per Texas Medicaid Provider Procedures Manual (TMPPM) Section 5.1, only wet or electronic signatures are accepted for prior authorizations. Prescribing or ordering providers, dispensing providers, clients’ responsible adults, and clients may sign prior authorization forms and supporting documentation using electronic or wet signatures. Stamped signatures, typed fonts, and images of wet signatures are not accepted. How this impacts...

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Provider Alert!
17Nov

Provider Alert! EVV Cures Act Home Health Care Services (HHCS): Onboard Now

Date: November 17, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Effective Date: January 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to remind program providers and financial management services agencies (FMSAs) who will be new to EVV, due to the Cures Act Home Health Care Services implementation, must complete onboarding and EVV Portal training by December 31. It's recommended to complete the form as soon as possible to be able to practice using EVV before the January...

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Provider Alert!
17Nov

Provider Alert! Timeframe for follow-up from an Inpatient Behavioral Health Facility

Date: November 17, 2023 Attention: Behavioral Health Providers and inpatient facilities Call to action: Texas Children’s Health Plan (TCHP) request that all members receiving inpatient psychiatric services be scheduled prior to discharge for outpatient or lower level of care follow-up with an in network behavioral health provider. To search for TCHP network behavioral health providers, click here. The timeframe requirements are as follows: Initial outpatient treatment after discharge must occur within seven (7) days from the date of discharge. The appointment should not occur...

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Provider Alert!
16Nov

Provider Alert! Texas Children’s Health Plan Celebrated Cultural Awareness Week

Date: November 15, 2023 Attention: All Providers Call to action: We are excited to announce that Texas Children’s Health Plan (TCHP) celebrated Cultural Awareness week, November 6-10, 2023! TCHP fosters an environment of diversity, equity and inclusion by providing the right resources for our network of providers to better serve our culturally diverse member population. During Cultural Awareness week we provided trainings and panels for our staff to better help them serve our diverse member population.   We invite you to learn more about...

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Provider Alert!
15Nov

Provider Alert! EVV Claims Matching Resumes January 1

Date: November 15, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Call to action: Texas Children’s Health Plan (TCHP) would like to remind program providers, financial management services agencies (FMSAs) and Consumer Directed Services (CDS) employers that Electronic Visit Verification (EVV) claims matching for all services required to use EVV will begin on January 1, 2024. EVV claims with dates of service on or after January 1 that do not have an EVV visit match, will be denied. Email TMHP to...

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Provider Alert!
08Nov

Provider Alert! Texas Children’s® Link: Setting up Challenge Questions

Date: November 7, 2023 Attention: All Texas Children's® Link Portal Users Call to action: Texas Children’s Hospital and Texas Children’s Health Plan have a responsibility to safeguard the privacy of all Texas Children’s Hospital patients and Texas Children’s Health Plan members and to protect the confidentiality of their health information. In order to help protect privacy and provide an easier way to reset passwords, we would like to invite all end users who use the Texas Children's® Link portal to set up...

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