Author - tcph

Provider Alert!
03Sep

Provider Alert! Inhaled Glucocorticoids and Insulin Products Return to Non-Preferred for Medicaid Members

Attention: All Providers Effective Date: September 18, 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: Beginning September 18, 2020 the Texas Vendor Drug Program (VDP) will restore non-preferred status to some of the inhaled glucocorticoids and insulin products. VDP temporarily removed non-preferred status from these...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert0 CommentsRead more...
Provider Alert!
02Sep

Provider Alert! 2020-21 RSV Season and Synagis (palivizumab)

Attention: All Providers Effective Date: September 24, 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: Respiratory Syncytial Virus (RSV) season is here! The Texas RSV region schedule and map can be found on the Texas Health and Human Services (HHSC) Vendor Drug Program (VDP) website. ...

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Provider Alert!
02Sep

Provider Alert! CMS Approves Multiple Allowances to Support Providers with Improving Performances and Incentive Payments Alike due to COVID-19 Pandemic

Attention: All Providers Effective Date: August 27, 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 you of the following notice from Health and Human Services Commission (HHSC). The COVID-19 pandemic has resulted in significant changes in care...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
25Aug

Provider Alert! Updates to the Provider Incentive Program

Attention: Primary Care Providers Effective Date: August 2020 Texas Children’s Health Plan would like to thank you for the dedication and care you continually provide to our valued members. We appreciate all your effort in improving the quality of care our members receive every day. Our HEDIS metrics are just one way we see that outcome, and it is reflected in our provider incentive program (PIP) results. We would like to share an update made to our PIP because of your...

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Provider Alert!
25Aug

Provider Alert! Outpatient Medical Drug Billing Requirements Reminder

Attention: All Providers Effective Date: September 1, 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: Effective September 1, 2020, TCHP will reject outpatient medical drug claims for clinician administered drugs (CADs) without the proper national drug code (NDC), healthcare common procedure coding system (HCPCS), and billing unit combination. The...

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Provider Alert!
06Aug

Provider Alert! Providers who are leaving the TCHP Participating Provider Network

Attention: All Providers Effective Date: State Fiscal QTR 3 & 4 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 and its continued governmental Emergency Declaration. CHANGES TO THE TCHP PARTICIPATING PROVIDER NETWORK The following is a list of providers and practitioners that have left and/or will be leaving...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
31Jul

Provider Alert! Child Psychiatry Access Network, free consultations for PCP’s caring for members with behavioral health concerns

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) collaborates with the Child Psychiatry Access Network (CPAN) who offers free consultations for Primary Care Providers (PCPs) who see children within the state of Texas.  CPAN is...

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Provider Alert!
31Jul

Provider Alert! Regulatory Guidelines & Appointment Availability Standards Reminder

Attention: Primary Care and Specialist 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 network providers of the appointment availability standards and regulatory requirements.  In 2015, Senate Bill 760 passed, requiring Texas Health and Human Services Commission...

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Provider Alert!
31Jul

Provider Alert! EVV Update: Information Letter (IL) for Financial Management Services Agencies (FMSAs)

Attention: Financial Management Services Agencies (FMSAs) Effective Date: November 19, 2020 Call to action: Health and Human Services Commission (HHSC) has extended the Electronic Visit Verification (EVV) practice period through December 31, 2020. This allows Consumer Directed Services (CDS) employers to learn more about using the EVV system. During the practice period, EVV claims will not be denied for a mismatch. Beginning January 1, 2021, all service visits for an EVV-required service must be captured in the EVV system. Claims without a matching...

By Office Managers, Primary Care Providers, Provider Alert, 0 CommentsRead more...
Provider Alert!
29Jul

Provider Alert! Vyondys-53 and Zolgensma updates

Attention: Neurologists Effective Date: July 1, 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: Vyondys-53 is a clinician-administered drug benefit of Texas Medicaid with the effective date of April 1, 2020, under the Healthcare Common Procedure Code (HCPCS) miscellaneous code J3490/C9399 and an...

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