Author - Texas Children's Health Plan
18Mar

Provider Alert! Coronavirus disease 2019 (COVID-19) and Pregnancy

The following provider guidance is provided as a Texas Children’s Health Plan (TCHP) educational communication only. As many of our network providers are affiliated with other institutions and organizations who also set policy and procedure, this communication is not intended to replace, overwrite, amend or append to another institution’s guidance, policy or procedure. TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event. Attention: OB/GYN Providers Effective March 18, 2020 While...

By OB/GYNs, , , 0 CommentsRead more...
18Mar

Provider Alert! Reporting Provider Office Closures and Changes due to COVID-19

Attention: All Providers Effective March 17, 2020 Reporting Provider Office Closures and Changes due to COVID-19 The severity of the Coronavirus disease 2019 (COVID-19) may have affected your ability to operate during normal business hours. If your office has made any changes to the regular business operations or has closed entirely and unable to provide services to our members at this time, please complete an online questionnaire on our main website, https://www.texaschildrenshealthplan.org/for-providers. Be sure to include any changes to your office status and the...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
17Mar

March is National Nutrition Month

The Academy of Nutrition and Dietetics recognizes March as National Nutrition Month. This month we focus on healthy living through nutrition, bite by bite. Make informed food choices by creating and planning healthy meals, every day, each week. Start each day with a healthy breakfast. Drink more water. Hydration is important for both physical and mental functioning. Get physically active. Plan your meals and prep ahead. Learn and implement proper portion sizes. Substitute meat for plant-based alternatives. Get at least 8 hours of sleep per day. When eating...

By Events, , , 0 CommentsRead more...
Provider Alert!
16Mar

Provider Alert! Health and Human Services (HHS) Promotes Women’s Health by Raising Awareness of Long-Acting Reversible Contraception (LARC)

Effective Date: March 5, 2020 The American College of Obstetricians and Gynecologists recommends LARCs for the following reasons: LARCs are the most effective reversible contraceptive method There is no further action required for the patient to avoid pregnancy after the device is in place LARCs have high rates of patient satisfaction and method continuation LARCs can be removed at any time if the patient plans to conceive or use another form of birth control How this impacts providers: Providers must decide if their patient qualifies as...

By OB/GYNs, Provider Alert, 0 CommentsRead more...
Provider Alert!
02Mar

Provider Alert! Additional development screenings and autism screenings now allowable and payable beyond the standard screenings

Effective Date: June 3, 2020 Attention: Primary Care Providers Call to action: In addition to the required screenings, TCHP is allowing for a total of 12 developmental screenings up to age 6 during a Texas Health Steps Checkup within the following ages: 8.1-  2 screenings At ages 0-11 months 8.2- 3 screenings At age 12-23 months 8.3- 2 screenings At ages 12-23 months 8.4- 2 screenings At ages 24-35 months 8.5- 1 screening At 3 years of age 8.6- 1 screening At 5 years of age 8.7-1 screening At 6 years of age   If a developmental or...

By Primary Care Providers, Provider Alert, 0 CommentsRead more...
Provider Alert!
02Mar

Provider Alert! Prosthetics Codes Update

Effective Date: June 3, 2020 Attention: Prosthetics, DME providers, orthopedists, podiatrists, PCPs Call to action: Texas Children’s Health Plan will now configure the prosthetics procedures codes to require prior authorization according to the Texas Medicaid Provider Procedures Manual (TMPPM).  Currently, the only procedure codes on the prior authorization list are related to Breast Reconstruction. How this impacts providers: Provider offices should utilize the Standard Prior Authorization Form for prosthetics that require a prior authorization: https://www.texaschildrenshealthplan.org/for-providers/provider-resources/prior-authorization-information Next steps for providers: Providers should reference the prosthetic procedure...

By Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
02Mar

Provider Alert! Provider Participation for Improved Texas Immunization Registry

Effective Date: February 28, 2020 Attention: Primary Care Providers Call to action: As you know, The Texas Immunization Registry, Immtrac2  manages the records for patients and makes them accessible for national and local stakeholders alike. Locally, school districts utilize Immtrac2 for eligibility when students enroll. It is important to ensure quality data is maintained and available so all health care providers have the ability to provider better and more reliable care. To achieve this, it is important that providers are active members...

By Provider Alert, , , 0 CommentsRead more...
Provider Alert!
01Mar

Provider Alert! Changes to the Prescription Monitoring Program Effective March 1st

The Texas Prescription Monitoring Program (PMP) Per the Texas State Board of Pharmacy1: The Texas Prescription Monitoring Program (PMP) is used to verify a practitioner’s own records and prescribing history as well as inquiring about patients. In addition, the program may be used to generate and disseminate information regarding prescription trends2. Beginning March 1, 2020, pharmacists and prescribers (other than a veterinarian) will be required to check the patient’s PMP history before dispensing or prescribing opioids, benzodiazepines, barbiturates, or carisoprodol. This applies to discharge/ambulatory medications only. Exceptions...

By Provider Alert, 0 CommentsRead more...
Provider Alert!
26Feb

Provider Alert! Updated Wheelchair Guidelines

Call to action: The purchase of a wheelchair is a benefit every five years, with the following guidelines: For current members who are twelve years of age and younger: The wheelchair frame must allow for at least a 3-inch growth potential in both width and depth. For current members who are 13 through 17 years of age: The wheelchair frame must allow for at least a 2 inch growth potential in both width and depth. For current members who are 18 years of...

By Provider Alert, , 0 CommentsRead more...
Provider Alert!
26Feb

Provider Alert! Updated: Non-Emergency Ambulance Guideline

Date: February 25, 2020 Attention: All providers Updates include the following change: for approved requests, TCHP will include one unscheduled trip (if not already requested) per month to the authorization request to allow access to transport for unscheduled trips. Reminders: Texas Children’s Health Plan does not accept authorization requests from ambulance/medical transportation vendors for non-emergency transport. Instead, a Medicaid-enrolled provider (physician, nursing agency, or other Medicaid provider) must submit a non-emergency ambulance authorization request. Non-emergency transport is defined as ambulance transport provided for a Medicaid...

By Provider Alert, 0 CommentsRead more...