Texas Children’s Health Plan – Page 95

21JanJanuary 21, 2016

Provider Alert! Annual Reminder on Copayments and Deductibles

To: All Texas Children’s Health Plan Providers Subject: Annual Reminder on Copayments and Deductibles Texas Children’s Health Plan will pay for a primary insurance deductible with proof of assignment to the deductible on the primary evidence of procedure. Payments will be made up to Medicaid allowable only. Claims for primary insurance copayments should be sent to Texas Medicaid and Healthcare Partnership directly. Texas Children’s Health Plan will not pay CP001 or CP002 on a claim as these are not payable by the managed...

By Texas Children's Health PlanOffice Managers, Provider Alertcopayments, deductibles, insurance, medicaid, provider alert0 CommentsRead more...

12JanJanuary 12, 2016

The Importance of Educating Patient’s Caregivers on Shaken Baby Syndrome

Shaken baby syndrome, or inflicted traumatic brain injury, is caused by the violent shaking of a child with or without contact between the child’s head and a hard surface. Such contact may result in head trauma, including subdural hematoma, diffuse axonal injury and retinal hemorrhage. Shaken baby syndrome, is the most common cause of traumatic death for children younger than 1 year. Approximately 20 per 100,000 infants per year experience abusive head injuries resulting from shaking typically triggered by a...

By Texas Children's Health PlanOB/GYNs, Primary Care Providersbabies, crying, head trauma, infants, parenting, parents, pediatric, period of purple crying, shaken baby syndrome0 CommentsRead more...

23DecDecember 23, 2015

Provider Alert! Billing Update for Texas Health Steps

To: All Texas Health Steps Providers Subject: Reminder – Billing for Texas Health Steps Services to Texas Children’s Health Plan Texas Children’s Health Plan follows the State of Texas Medicaid guidelines for Texas Health Steps checkups including the following: “Texas Health Steps medical checkups reflect the federal and state requirements for a preventive checkup. Preventive care medical checkups are a benefit of the Texas Health Steps program if they are provided by enrolled Texas Health Steps providers and all of the required components...

By Texas Children's Health PlanOffice Managers, Primary Care Providers, Provider Alertcheckups, periodicity, preventive care, provider alerts, providers, texas health steps, th steps0 CommentsRead more...

23DecDecember 23, 2015

Provider Alert! Long Acting Reversible Contraception (LARC) Billing Changes

To: All Providers and Facilities Subject: Long Acting Reversible Contraception (LARC) Billing Changes Recent changes at Health and Human Services Commission (HHSC) has improved the accessibility of LARC devices for Medicaid members. HHSC is currently working to add ParaGard, Nexplanon and Liletta to the Medicaid Vendor Drug Program formulary. More information on these products and the process to order will be supplied as these are added. Once added, providers may choose to continue to “buy and bill” or they may choose to...

By Texas Children's Health PlanOB/GYNs, Office Managers, Provider Alertbilling, contraception, hhsc, insurance, LARC, medicaid, provider alert, provider relations, reversible contraception0 CommentsRead more...

23DecDecember 23, 2015

Vaccines and Pregnancy

By Dr. Lisa Hollier, MD MPH Chief Medical Officer Texas Children’s Health Plan Professor, Maternal-Fetal Medicine Director, Health Policy Division, Baylor College of Medicine Pregnant women, along with their fetuses, are particularly vulnerable to vaccine-preventable disease-related complications. The Centers for Disease Control and Prevention (CDC) have made recommendations for adult vaccines and there are two that are directly recommended for administration during pregnancy, four are recommended in pregnancy based on additional risk factors, and two are specifically recommended during the postpartum period (see table)....

By Texas Children's Health PlanOB/GYNsfetal, GBS, group b, gynecologist, gynecology, immunization, influenza, maternal, OB, Obstetrics, pregnancy, RSV, tdap, vaccination, vaccines0 CommentsRead more...

21DecDecember 21, 2015

Red Eyes – Getting the Treatments Right!

Conjunctivitis comes in three forms: Pearls: PURULENT DISCHARGE (PUS) distinguishes Bacterial from Viral Conjunctivitis PRE-AURICLULAR LYMPH NODE swelling suggests Viral Conjunctivitis ITCHING distinguishes Allergic from Viral Conjunctivitis Katherine K. Wang, PharmD. Clinical Pharmacist Texas Children's Hospital at The Center for Children and Women Joung A. Choi, PharmD. Pharmacy Manager Texas Children's Hospital at The Center for Children and Women Harold J. Farber, MD, MSPH, FAAP Associate Medical Director Texas Children’s Health Plan Associate Professor of Pediatrics, Baylor College of Medicine Zaina Al-Mohtaseb, MD Assistant Professor of Ophthalmology & Associate Residency Program Director Baylor College of Medicine References: Jacobs...

By Texas Children's Health PlanPrimary Care Providersallergen, allergic conjunctivitis, bacterial conjunctivitis, conjunctivitis, opthalmic, pink eye, red eye, viral conjunctivitis0 CommentsRead more...

01SepSeptember 1, 2015

Provider Alert! Preventing Pre-Term Pregnancies

To: All Providers Subject: Effective September 1, 2015 all Progesterone therapy will require a pre-authorization from Texas Children’s Health Plan. Claims billed using the branded Makena will no longer require a U1 modifier. Pre-authorized use of Makena (hydroxyprogesterone caproate injection) will need to be submitted as J1725 with the appropriate NDC information as required on all claims. Claims billed using the compounded 17-P therapy will now require the U1 modifier. Pre-authorized use of 17-P will need to be submitted as J1725 with the...

By Texas Children's Health PlanOB/GYNs, Provider Alertclaims, pre-authorization, pre-term, pregnancy, pregnant, progesterone, provider alert, providers0 CommentsRead more...

Author - Texas Children's Health Plan