Author - tcph

Provider Alert!

Provider Alert! ZZ Taxonomy Qualifier Requirement and Billing Taxonomy Reminder

Date: September 23, 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: Texas Children’s Health Plan would like to provide guidance for the ZZ taxonomy qualifier and the billing taxonomy claims requirements. How this impacts providers: ZZ Taxonomy Qualifier: This communication is to notify [...]

Provider Alert!

Provider Alert! Coding Guidance for Identifying Members for Case Management

Date: August 22, 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: Texas Children’s Health Plan (TCHP) has an extensive case management program available to our Members. To find out more information on this program, please see our provider manuals. While active [...]

Provider Alert!

Provider Alert! EVV Direction for FMSAs on CDS Employer Usage

Date: August 1, 2022 Attention: FMSA and Consumer Directed Services Employers Effective date: September 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. Call to action: The purpose of this communication is to inform Texas Children’s Health Plan (TCHP) financial management services agencies (FMSAs) and [...]

Provider Alert!

Provider Alert! Novavax COVID-19 Vaccine Coverage Update

Date: July 29, 2022 Attention: All Providers Effective date: July 13, 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: Texas Children’s Health Plan (TCHP) would like to inform providers that on July 13, 2022, the U.S. Food and Drug Administration (FDA) issued an emergency [...]

Provider Alert!

Provider Alert! Approved in-office lab list

Date: July 20, 2022 Attention: All Providers Effective date for procedure code 83655, lead screening: June 22, 2021 Call to action: This alert is to serve as a reminder of the specific labs on our pre-approved list that may be run in a network provider’s office. How this impacts providers: Providers may perform specific point of care lab tests in their office and receive reimbursement from TCHP. All other lab tests should be referred to TCHP in network labs or State of Texas [...]

Provider Alert!

Provider Alert! Removal of Specialist Requirements from CAD Clinical Policies and Prior Authorization Criteria

Date: July 13, 2022 Attention: Providers Effective Date: August 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: HHSC is updating the prior authorization criteria for some clinician administered drugs. How this impacts providers: HHSC will no longer require the prescription include consultation with or [...]

Provider Alert!

Provider Alert! All MCOs: Dupixent, Evrysdi, and Qelbree Clinical Prior Authorization Criteria Updates

Date: July 13, 2022 Attention: Providers Effective Date: August 2, 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: HHSC is revising the prior authorization (PA) criteria for the following drugs: Dupixent, Evrysdi and Qelbree. How this impacts providers: HHSC made the following revisions: Dupixent clinical PA [...]

Provider Alert!

Provider Alert! Removal of Specialist Requirements from CAD Clinical Policies and Prior Authorization Criteria

Date: July 13, 2022 Attention: Providers Effective Date: August 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: HHSC is updating the prior authorization criteria for some clinician administered drugs. How this impacts providers: HHSC will no longer require the prescription include consultation with or [...]

Provider Alert! Pediatric Updates for Moderna & Pfizer-BioNTech COVID-19 Vaccines

Date: July 12, 2022 Attention: All Providers Effective Date: June 17, 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: Texas Children’s Health Plan (TCHP) would like to inform providers that on June 17, 2022, the U.S. Food and Drug Administration (FDA) authorized emergency use [...]

Provider Alert!

Provider Alert! Reimbursement for in-office Durable Medical Equipment and Medical Supplies

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. Call to action: The purpose of this communication is to clarify the payable Durable Medical Equipment (DME) Codes that physicians are allowed for reimbursement. DME or medical supply [...]