Author - Texas Children's Health Plan
17Jul

Provider Alert! Coding Changes to Postpartum Depression Screening

Maternal depression is a serious and prevalent condition that not only affects the mother, but may present a substantial early risk to appropriate child development, the mother-infant bond, and the family. According to the AAP, it has been estimated that 5 percent to 25 percent of all pregnant, postpartum, and parenting women have some type of depression. Mothers who have low incomes are more likely to experience some form of depression than the general population of mothers. A maternal depression...

By OB/GYNs, Provider Alert, , , 0 CommentsRead more...
11Jul

Immediate postpartum long-acting reversible contraceptives (LARCs): claim processing procedure update

Long-acting reversible contraceptives (LARCs) are beneficial to subsequent maternal health outcomes as they enhance family planning and safer birth spacing. The Texas Medicaid Provider Procedures Manual was updated earlier this year to reflect new language related to immediate postpartum LARC device insertion. Language in subsection 2.2.5.4, “Immediate Postpartum Insertion of IUDs and Implantable Contraceptive Capsules” was updated regarding immediate postpartum LARC insertion and claim processing procedures. The new language states that procedure codes for LARCs may be reimbursed in addition to...

By OB/GYNs, Office Managers, , , , , 0 CommentsRead more...
05Jul

Update to reimbursement code for sports and camp physicals

Effective: For dates of service beginning January 1, 2017 As a value added service to CHIP and STAR Members under 21, Texas Children’s Health Plan will reimburse code 97169 – Athletic Training Evaluation, low complexity. This code is only reimbursed for sports and camp physicals when a member has also had a THSteps or well child visit within the previous 12 months. (Code 97169 will be the only code that is accepted for reimbursement, use of any other Athletic Training...

By Office Managers, Primary Care Providers, , , 0 CommentsRead more...
02Jul

Texas Health Steps Medical Checkup Periodicity Schedule

The  Texas Health Steps Medical Checkup Periodicity Schedule for infants, children, and adolescents (birth through 20 years of age) specifies when each age-specific checkup is due and which checkup components are required. The periodicity schedule is posted on the Texas Health Steps website and is updated when policy changes are made which affect checkup components or the ages at which checkup components are required.  A Texas Health Steps Checkup is complete only if it documents all required components or if the...

By Office Managers, Primary Care Providers, , , 0 CommentsRead more...
29Jun

Preferred lab provider: Quest Diagnostics

As you know, Texas Children’s Health Plan entered into an agreement with Quest Diagnostics to serve as our exclusive reference lab provider, effective January 1, 2015. Per state regulations, laboratory specimens that are required to be sent to state laboratories for processing will continue to follow guidelines provided in the Texas Medicaid Provider Procedures Manual (TMPPM). If you do not currently have a relationship with Quest Diagnostics, you will be contacted by a Texas Children’s Health Plan or Quest Diagnostics representative to...

By OB/GYNs, Office Managers, Primary Care Providers, Specialists, , , , 0 CommentsRead more...
20Jun

Hospital – Facility Billing Neonatal Claims Must Submit Application for Neonatal Level of Designation before July 1, 2018

Attention:  All Hospitals Subject:  Hospitals Billing Neonatal Claims Must Submit Application for Neonatal Level of Designation before July 1, 2018 Effective immediately, hospitals rendering neonatal services must submit their neonatal designation applications to the Texas Department of State Health Services. Completed applications must be submitted before July 1, 2018. Applications received after July 1 will not be considered for approval. If an application is received after July 1, it will not be considered as submitted in time for approval by the executive commissioner before...

By Facilities, , , 0 CommentsRead more...
15Jun

Save the Date: September 13 CME Disparities in Care

Grand Rounds CME Series:  Disparities in Care September 13, 2018 Event will be broadcasted. Additional event information to come. Stay up-to-date by checking www.TexasChildrensHealthPlan.org/CME. Provided by Texas Children’s Hospital and presented by Texas Children’s Health Plan

By OB/GYNs, Primary Care Providers, Specialists0 CommentsRead more...
Provider Alert!
14Jun

Provider Alert! Services for Priority Populations with Substance Use Disorder

Attention:  Behavioral Health & OB/GYN Providers Subject:  Services for Priority Populations with Substance Use Disorder   The Texas Health and Human Services is committed to providing services for people with substance use disorders. Pregnant women and women with dependent children are identified as priority populations to receive services funded through the Substance Abuse Prevention and Treatment Block Grant. To find out more please visit Texas Health and Human Services at https://hhs.texas.gov/services/mental-health-substance-use/adult-substance-use

By Provider Alert0 CommentsRead more...
Provider Alert!
11Jun

Provider Alert! OB Provider Incentive Program Updates

Attention:  OB Provider Groups Subject:  OB Provider Incentive Program Updates   Texas Children’s Health Plan (TCHP) is pleased to announce the updated OB Provider Incentive Program. The purpose of the program is to continue rewarding the OB provider groups for providing quality care to our members during their pregnancy, from early prenatal care to delivery and timely postpartum care.   Attached is the OB Provider Incentive Program brochure for your review. TCHP will host a webinar (12:00pm-1:00pm, June 21st, 2018) to explain the structure of...

By OB/GYNs, Provider Alert0 CommentsRead more...
07Jun

Prescription medications and photosensitivity

Summertime means more time spent in the sun, so it is important to remind your patients of the risk of increased photosensitivity when taking certain prescription medications. Photosensitivity is particularly common in two classes of prescription drugs: acne medications and antibiotics. The prescription information your patients receive will warn them of the risk, but it is also key for you to advise your patients about this potential side effect. When prescribing one of these medications, recommend that your patients either...

By OB/GYNs, Primary Care Providers, Specialists, , , , 0 CommentsRead more...