Author - tcph

Provider Alert!
03Aug

Provider Alert! HHS Primary Health Care Services Program

Date: August 3, 2021 Attention: Primary Care 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) would like to remind providers of the Primary Health Care (PHC) Services Program made available from Health and Human Services (HHS). Primary Health Care...

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Provider Alert!
04Jun

Provider Alert! Reimbursement Reminder for Outpatient Surgical Procedure Codes

Date: June 4, 2021 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) would like to provide information to providers that TCHP follows Health and Human Services Commission (HHSC) guidance for outpatient surgical procedure reimbursement. Payments for...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
04Jun

Provider Alert! Amondys 45 has added a New code- J426

Date: December 17, 2021 Attention: Neurologists Effective Date: October 1, 2021 for Code J426 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: Update effective October 1, 2021, Amondys 45 new code J1426 is allowable with prior authorization for STAR, STAR KIDS, and CHIP. Texas Children’s Health Plan...

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Provider Alert!
26Mar

Provider Alert! Clinical Prior Authorization Updates for Epidiolex

Date: March 26, 2021 Attention: Neurologists Effective Date: May 11, 2021 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: Effective May 11, 2021, the Texas Health and Human Services Commission (HHSC) will update the ICD-10 diagnosis codes for Epidiolex (cannabidiol) for consistency with diagnosis codes...

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Provider Alert!
25Mar

Provider Alert! Clinical Prior Authorization Updates for Cytokine and CAM Antagonist Agents

Date: March 25, 2021 Attention: Gastroenterologists, Rheumatologists Effective Date: May 4, 2021 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: Effective May 4, 2021, the Texas Health and Human Services Commission (HHSC) will update the cytokine and cell-adhesion molecule (CAM) antagonist agents prior authorization criteria...

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Provider Alert!
18Mar

Provider Alert! Diabetes Awareness and Wellness Network (DAWN) Center

Date: March 18, 2021 Attention: Primary Care Providers and Endocrinologists 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) is happy to announce that we have partnered with the Diabetes Awareness and Wellness Network (DAWN) Center to serve as a viable...

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Provider Alert!
16Mar

Provider Alert! Prior Authorization Requirements for Incontinence Supplies

Date: March 15, 2021 Attention: All Providers Effective Date: December 22, 2020 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 network providers of the prior authorization requirements for incontinence supplies.   How this impacts providers: Incontinence supplies (diapers, wipes, and under pads) may be considered for members age 3...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
12Feb

Provider Alert! Subject: Prior Authorization Guideline updates for Private Duty Nursing (PDN)

Attention: All Providers Effective Date: March 1, 2021 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: TCHP would like to inform you of recent updates to the prior authorization requirements and the effective dates. Updates include the following: Private Duty Nursing, effective March 1, 2021: Nursing notes,...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
12Feb

Provider Alert! Attention: Behavioral Health Providers and inpatient facilities

Attention: Behavioral Health Providers and inpatient facilities 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 remind network providers that we require all members receiving inpatient psychiatric services to be scheduled prior to discharge for outpatient follow-up...

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Provider Alert!
02Feb

Provider Alert! Colorectal Cancer Screening Benefit Criteria to Change for Texas Medicaid

Attention: PCPs and Oncologists Effective Date: March 1, 2021 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: Effective for dates of service on or after March 1, 2021, colorectal cancer screening benefit criteria will change for Texas Medicaid. Fecal occult blood tests, multi-targeted stool deoxyribonucleic...

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