Author - Texas Children's Health Plan

Provider Alert!

Provider Alert! Telemedicine/Telehealth claims guidance

Date: November 21, 2022 Attention: All Providers Effective Date: October 25, 2022 Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission. The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March 31, 2022 as announced by the Health...

Provider Alert! COVID-19 UPDATE ALERT #4 – Telemedicine Services – Physicians, BH, FQHC and RHC Providers

Date: November 21, 2022 Attention: All providers Effective Date: October 25, 2022    The content in this message on Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission. The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March...

Provider Alert! Guidance on Appeals and Fair Hearing Requests due to COVID-19

Date: November 21, 2022 Attention: All providers Subject: Effective Date: October 25, 2022 The content in this message will remain in effect through November 30, 2022 as announced by the Health and Human Services Commission (HHSC). TCHP COVID-19 Utilization Management Procedure and provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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...

Provider Alert!

Provider Alert! Former Provider Portal Health Trio will not be Accessible after December 31, 2022

Date: November 18, 2022 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 purpose of this communication is to inform our network providers that the former provider portal platform, Health Trio, will no longer be accessible after December 31, 2022. How this...

Provider Alert!

Provider Alert! This season a flu vaccine is more important than ever.

Attention Primary Care Providers: Flu season is upon us, and while it is not possible to say what will happen this winter, the Center for Disease Control (CDC) believes we might have an early and possibly severe season due to reduced population immunity. For this reason, it’s important we vaccinate ourselves and our patients to avoid serious complications from the flu and to prevent unnecessary medical visits and hospitalizations, which further strain the healthcare system.  Every person 6 months and older should be...

Provider Alert!

Provider Alert! CGRP Antagonists- Prophylaxis, Prior Authorization Revision Scheduled for November 22, 2022

Date: November 14, 2022 Attention: Providers Effective Date: November 22, 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) will revise clinical prior authorization (PA) criteria for calcitonin gene-related peptide (CGRP) Antagonists-Prophylaxis. TCHP will separate renewal criteria from the initiation of...

Provider Alert!

Provider Alert! Annual Review of Clinical Prior Authorization Criteria Guides

Date: November 14, 2022 Attention: Providers Effective date: November 29, 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) will revise the following clinical prior authorization criteria: Epidiolex, GLP-1 Receptor Agonists, Lovaza & Vascepa by November 29, 2022. The changes will...

Provider Alert! Texas Children’s Health Plan Celebrates Cultural Competency Week

Date: November 14, 2022 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:  We’re excited to announce that Texas Children’s Health Plan (TCHP) will be celebrating Cultural Competency week, November 14-18, 2022! In doing so, we invite you to view our new video...

Provider Alert! COVID-19 Vaccine Administration Procedure Code 0044A is Now a Benefit of Medicaid and CHIP

Date: November 11, 2022 Attention: All Providers Effective date: Dates of service on or after October 19, 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 Health Plan (TCHP) would like to inform providers that effective for dates of service on or...

Provider Alert! Younger Age Groups Now Eligible For Bivalent COVID-19 Booster Vaccines

Date: November 10, 2022 Attention: All Providers               Effective date: October 12, 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 the recent changes to the eligible age groups for booster vaccines. On October 12,...