News Blog
21Mar

Provider Alert! Reinstatement of CHIP Co-pays for Medical Office Visits

Date: March 20, 2023 Attention: All Providers Effective Date: May 12, 2023 Call to action: In response to the COVID-19 public health emergency (PHE), the Health and Human Services Commission (HHSC) waived co-pays for Children’s Health Insurance Program (CHIP) medical office visits beginning March 13, 2020. HHSC will reinstate co-pays for CHIP medical office visits on May 12, 2023, because the federal PHE ends on May 11, 2023. The reinstatement of medical office visit co-pays does not apply to: COVID-19-related office visits for COVID-19...

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17Mar

Provider Alert! Medicaid Coverage Changes Are Coming- How Providers Can Assist Their Patients and What Steps Texas Children’s Health Plan (TCHP) is taking to Help Members

Date: March 17, 2023 Attention: All Providers Coverage change effective date: April 1, 2023 Call to action: As you may know, the Medicaid and/or CHIP coverage rules will soon be changing and all members will need to go through the process to determine their eligibility for coverage. Beginning, April 1, 2023, some of our members will be required to renew their Medicaid and/or CHIP coverage or risk losing their plan and access to healthcare. Others will have to go through this process...

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15Mar

Provider Alert! Subject: Respiratory Syncytial Virus (RSV) Season Ended on March 1

Date: March 14, 2023 Attention: Providers Effective Date: March 1, 2023 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 March 1, 2023, the Texas Health and Human Services (HHSC) closed Respiratory Syncytial (RSV) season’s Synagis prophylaxis therapy in all regions. This is in response...

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15Mar

Provider Alert! TCHP Psychotropic Medication Utilization Review (PMUR

Date: March 14, 2023 Attention: Pediatricians, Psychiatrists Call to action: Texas Children’s Health Plan (TCHP) utilizes a PMUR program to promote safe prescribing of behavioral health medications to children and adolescents. TCHP identifies potential “prescribing outliers” using parameters established by the Texas Health and Human Services (HHSC). This does not mean the prescribing is wrong or harmful to the child, but requires additional review due to potential for adverse reactions, polyprescribing, and other implications. Who is identified for review? Members under the age of...

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Provider Alert!
10Mar

Provider Alert! Recent Claim Denials Issued in Error are now Being Corrected

Date: March 10, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) is currently addressing recent claim denials that originated from an internal system error. How this impacts providers: No action is required by Providers. TCHP is working diligently to have the system corrected and will reprocess all impacted claims that denied in error by March 24, 2023. The EOP Message for impacted claims: This Provider was not certified/eligible to be paid for this procedure/service on this date of service. Next...

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Provider Alert!
09Mar

Provider Alert! You’re Invited to Our Provider Advisory Group!

Date: March 9, 2023 Attention: All Providers Event dates for the upcoming sessions are based on Service Delivery Area: Thursday, March 23, 2023 Northeast SDA Tuesday, March 28, 2023 Jefferson SDA Thursday, March 30, 2023 Harris SDA All sessions will be from 6:00-7:30PM CST Call to action: Texas Children’s Health Plan (TCHP) invites you to join our quarterly Provider Advisory Group (PAG). We will hold our next round of sessions later this month and dates are based on Service Delivery Area as described above. Click...

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Provider Alert!
09Mar

Provider Alert! Texas Children’s Health Plan announces Partnership with ProgenyHealth

Date: March 8, 2023 Attention: All Providers Effective date: June 12, 2023 Call to action: Texas Children’s Health Plan (TCHP) is happy to announce a partnership with ProgenyHealth, a company which specializes in Neonatal Care Management Services to support our Maternal Health Program. This is an exciting opportunity to partner with our providers for optimal neonatal intensive care unit (NICU) care and enhanced service to our members after NICU discharge through the first year of life. This partnership with ProgenyHealth will support our...

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Provider Alert!
08Mar

Provider Alert! Claims Editing System Reminder

Date: March 8, 2023 Attention: All Providers Call to action: As a reminder, providers are required to bill following the guidance of the CMS and Texas Health and Human Services guidelines. All providers should stay current with these guidelines. Medicaid National Correct Coding Initiative (NCCI) edits may be found at: https://www.medicaid.gov/medicaid/program-integrity/ncci/edit-files/index.html Next steps for providers: Providers should share this communication with their billing staff and confirm that their claims processing systems are configured correctly according to the guidelines provided in the links above. If...

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Provider Alert!
03Mar

Provider Alert! Provider Enrollment and Management System (PEMS) Master Provider File Launch Date has been Postponed

Date: March 1, 2023Attention: 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 inform providers that the launch date for the Provider Enrollment and Management System (PEMS) Master Provider File (MPF) and decommissioning of the...

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Provider Alert!
28Feb

Provider Alert! CHIP State Plan Amendment Reducing Insulin Copays for Certain Members

Date: February 28, 2023 Attention: Primary Care Providers and Endocrinologists Effective date: June 1, 2023 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: The copay charge for brand insulin drugs will be reduced beginning June 1, 2023 from $35 to $25 for CHIP members with incomes...

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