News Blog

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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Provider Alert!
22Feb

Provider Alert! Enfamil Prosobee Recall Information

Date: February 22, 2023  Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) received an urgent notice of Reckitt’s voluntary recall of two select batches of ProSobee plant-based infant formulas due to a possibility of cross-contamination with Cronobacter Sakazakii. TCHP wanted to ensure that our providers are aware of this important Member safety matter and are prepared to assist our Members in obtaining appropriate replacement formulas. Please inform Members DO NOT USE: Product: Enfamil ProSobee Powder, 12.9 oz Can Global Batch Code: ZL2HZF UPC: 300871214415 Lot...

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Provider Alert!
21Feb

Provider Alert! Asthma Reports Now Available on Texas Children’s Link, the Provider Portal

Date: February 21, 2023  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: TCHP is excited to share that we have added a NEW report to our Provider Portal. You can now locate your Asthma High Risk Reports on Texas Children’s Link....

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Provider Alert!
16Feb

Provider Alert! Changes to Lovaza Clinical Prior Authorization Scheduled for March 21, 2023

Date: February 15, 2023 Attention: Providers Effective Date: March 21, 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 Texas Health and Human Services (HHS) will revise the Lovaza clinical prior authorization criteria guide to include any covered omega-3 fatty acids drugs. How this impacts providers: ●      The...

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Provider Alert!
15Feb

Provider Alert! Reimbursement Update for Procedure Codes Pending a Rate Hearing

Date: February 14, 2023  Attention: All Providers Effective date: May 8, 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: Beginning May 8, 2023, TCHP will follow the Texas Medicaid Provider Procedures Manual (TMPPM) guidance regarding claims and the procedure codes that are pending a rate...

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14Feb

Provider Alert! COVID-19 UPDATE ALERT #4 – Telemedicine Services – Physicians, BH, FQHC and RHC Providers

Date: February 10, 2023 Attention: All providers  Effective Date: January 30, 2023 The content in this message on Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission. The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March...

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