Author - Texas Children's Health Plan

Provider Alert!
01Jul

Provider Alert! End of Reconsideration Process for Denied services

Date: July 1, 2022 Attention: All Providers   Effective date: August 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to...

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Provider Alert!
30Jun

Provider Alert! Coram Infusion Pharmacies: Eliminating Certain Services in Texas

Date: June 29, 2022 Attention: Primary Care Providers and Referring Providers Effective Immediately Call to action: Coram Infusion Pharmacies informed TCHP that it will no longer support certain post-acute infusion therapies such as TPN, antibiotics, inotropes, and hydration in Texas. However, Coram will continue to provide specialty pharmacy and enteral feedings. How this impacts providers: TCHP will work with Coram Infusion Pharmacies to assist Members currently receiving eliminated services. To ensure there is no disruption in care, TCHP will coordinate transition of infusion...

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30Jun

Provider Alert! Mental Health and Substance Use Disorder Outpatient & Residential Services Co-Payments Prohibited

Date: June 29, 2022 Attention: Behavioral Health Providers Effective date: July 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required...

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Provider Alert!
30Jun

Provider Alert! Tezspire (Tezepelumab-ekko) Update Effective July 1

Date: June 28, 2021 Attention: All Providers Effective Date: July 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal...

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30Jun

Provider Alert! COVID-19 Guidance for FMSAs and CDS Employer Orientations

Date: June 27, 2022 Attention: FMSA providers Effective Date: June 23, 2022 The content in this message will remain in effect through August 31, 2022, as announced by the Health and Human Services Commission. Effective February 1, 2022, FMSAs can permanently conduct new employer orientation virtually (i.e. audio-visual) in addition to allowing in-person orientations, based on member preference. COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts...

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Provider Alert!
30Jun

Provider Alert! Prior Authorization Criteria Update for Rinvoq and Cibinqo

Date: June 28, 2022 Attention: All Providers Effective Date: August 31, 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal...

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30Jun

Provider Alert! Provider Information – Patient’s Medicaid Coverage may be Impacted by the end of the COVID-19 Public Health Emergency

Date: June 23, 2022 Attention: All Providers Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 provide you an update in regards to member’s Medicaid coverage and the upcoming conclusion of the public health emergency (PHE). The federal...

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Provider Alert!
17Jun

Provider Alert! Treatment Indications to Change for Ferric Carboxymaltose

Date: June 17, 2022 Attention: All Providers Effective Date: July 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal...

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Provider Alert!
15Jun

Provider Alert! Prior authorization criteria for Voxzogo (Vosoritide)

Date: June 15, 2022 Attention: All Providers Subject: Prior authorization criteria for Voxzogo (Vosoritide) Effective Date: July 15, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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: Effective July 15, 2022, Texas Children’s Health Plan (TCHP) will implement the Voxzogo clinical edit in-line with the Health and...

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Provider Alert!
15Jun

Provider Alert! Respiratory Syncytial Virus (RSV) Prophylaxis Season Reopening in All Regions

Date: June 15, 2022 Attention: All Providers Subject: Respiratory Syncytial Virus (RSV) Prophylaxis Season Reopening in All Regions Effective Date: June 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 that the Health and Human Services Commission...

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