Author - Texas Children's Health Plan

Provider Alert! Service Planning for Pregnant Women during COVID-19

Attention: OB/GYN Providers Effective Date: May 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) is aligned with Health and Human Services Commission (HHSC) guidance regarding outreach and education for pregnant members. As part of the routine care [...]

Provider Alerts! CHIP co-pays waived for office visits in response to COVID-19

Attention: All Providers Effective Date: May 22, 2020 Effective May 22, 2020, HHSC has extended the end date for the information contained in this notice to June 30, 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: To help families in accessing care during the [...]

Provider Alert!

Provider Alert! Adakveo Update

Attention: Hematologists Effective Date: May 26, 2020 Call to action: Adakveo, Injection, crizanlizumab - clinician administered drug HCPCS code C9053 is an at risk drug. Currently, there is no prior authorization required; however, beginning May 26, 2020 authorization guidelines will be in place. The required criteria to receive Adakveo include: HbSS (sickle cell) diagnosis Patients over the age of 16 years-old Patients that have experienced more than two vaso-occlusive crisis (VOC) events in the past 12-months How this impacts providers: Prescribers should adhere to the guidelines and [...]

Provider Alert!

Provider Alert! Housing Choice Plan Survey

Attention: All Providers Effective Date: Survey open May 15, 2020 until June 15, 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: The Health and Human Services Commission’s (HHSC) Behavioral Health Advisory Committee has approved the development of a Housing Choice Plan for individuals [...]

Provider Alert! COVID-19 Disaster Declaration – COVID-19 Testing expanded to include Out-of- Network (OON) Laboratories

Attention: All Providers Effective Date: April 14, 2020 NOW THROUGH JUNE 30, 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: Quest Diagnostics (Quest) is TCHP’s exclusive lab provider.  Quest is continuously working to expand their capacity for COVID-19 testing and ensure timely turnaround [...]

Provider Alert! HHSC Electronic Visit Verification Temporary EVV Policies for Novel Coronavirus (COVID-19)

Attention: LTSS Providers Effective Date: March 21, 2020 – June 30, 2020 Effective May 22, 2020, HHSC has extended the end date for the information contained in this notice to June 30, 2020. TCHP network 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: In response to the novel coronavirus [...]

Provider Alert! Signature requirement waived on DME Forms due to COVID-19

Attention: DME Providers Effective Date: May 22, 2020 Effective May 22, 2020, HHSC has extended the end date for the information contained in this notice to June 30, 2020 TCHP network 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: To help ensure continuity of care during the COVID-19 [...]

National Blood Pressure Awareness Month

Blood pressure is the pressure of blood pushing against the walls of your arteries. Hypertension, also known as high blood pressure, is the force of your blood against the walls of your blood vessels. Hypertension increases the risk for heart disease and stroke. Sponsored by the Centers for Disease Control and Prevention (CDC) and recognized by the National Heart, Lung and Blood Institute (NHLBI), National High Blood Pressure Awareness Month raises awareness about the impact of hypertension (healthinsight.org). High Blood [...]

Provider Alert! COVID-19 Disaster Declaration – ALERT #5 – Prior Authorization Adjustments

Attention: All Providers Effective Date: May 22, 2020 Effective May 22, 2020, HHSC has extended the end date for the information contained in this notice to June 30, 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: As are result of the COVID-19 Disaster Declaration, TCHP [...]

Provider Alert!

Provider Alert! Secretion and Mucous Clearance Devices

Attention: Pulmonologists and DME providers Effective Date: June 3, 2020 Call to action: Secretion and mucous clearance devices will require prior authorization except for percussion cups. Here is the link to the Prior Authorization Form: http://www.tmhp.com/Provider_Forms/PA_Forms/F00145_Prior_Auth_for_Secretion_and_Mucus_Clearance_Devices_Initial.pdf Information on coding for devices: Device Code Intrapulmonary Percussive Ventilation (IPV)* E0481. TCHP will no longer accept E1399. This is not a current benefit of Texas Medicaid and will be reviewed by the TCHP Medical Director on a case- by-case basis. Percussion cup E1399 purchase only. Does not require a Prior Authorization. Electrical percussors E0480 [...]