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Provider Alert!
24May

Provider Alert! Clinical Prior Authorization Updates for Enzymes

Date: May 20, 2021 Attention: Geneticists, Hematologists, and Oncologists Effective Date: June 30, 2021 Call to action: Effective June 30, 2021, the Texas Health and Human Services Commission (HHSC) will update the enzymes prior authorization criteria to reflect recent FDA-approved administration changes. This impacts the following agents: Adagen (pegademase bovine), Ceprotin (protein C concentrate), Fabrazyme (agalsidase beta), and Revcovi (elapegademase). Adagen (J2504 procedure code) has been discontinued by the manufacturer. Ceprotin 400-600 units vial is no longer available through retail pharmacy benefits. The Ceprotin 400-600 units...

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20May

Provider Alert! Adolescent Eligibility for Pfizer-BioNTech COVID-19 Vaccine

Date: May 20, 2021 Attention: All Pediatric and Family Medicine Providers Effective Date: May 12, 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: Texas Children’s Health Plan (TCHP) would like to make network providers aware of new guidance approved by the Food and Drug Administration...

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Provider Alert!
17May

Provider Alert! After hours Codes Reminder

Date: May 14, 2021 Attention: PCPs and Urgent Care 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: TCHP would like to remind providers of Medicaid After-Hours Procedure Codes that do not require prior authorization. How this impacts providers: Below are the Medicaid Payable After-Hours Procedure...

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Provider Alert!
12May

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

Date: May 12, 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) collaborates with the Child Psychiatry Access Network (CPAN) who offers free consultations for Primary Care Providers (PCPs) who see children within the state of...

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Provider Alert!
11May

Provider Alert! Developmental and Mental Health Screening Tools Added for the THSteps Preventive Care Medical Checkups

Date: May 11, 2021 Attention: Pediatric Providers Effective Date: June 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: Texas Children’s Health Plan would like to inform network providers of two new developmental and mental health-screening tools that will be added to the Texas Health...

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06May

Provider Alert! COVID-19 Pediatric Provider Enrollment

  Date: May 7, 2021 Attention: All Pediatric 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 inform network providers that the Texas Department of State Health Services (DSHS) Immunization Unit is encouraging all pediatric providers to enroll in...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, Uncategorized, , , , 0 CommentsRead more...
05May

Provider Alert! Texas Children’s Health Plan to host special live CME event

Recognizing the Need for Referrals for Common Diseases Identify the most common issues with cardiac, infectious and respiratory diseases and recognize when specialist referrals are necessary. This is a free, online CME course for contracted providers of the health plan provided by Texas Children’s Hospital. Thursday, May 27, 2021 – 5:30 p.m. – 7:30 p.m. – Live stream via WebEx CME Objectives: Identify the most common cardiac issues encountered in a General Pediatric Clinic and recognize when Cardiology referrals are necessary Identify common infectious disease...

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Provider Alert!
28Apr

Provider Alert! FMSA Cost Survey

Date: April 28, 2021 Attention: Financial Management Services Agencies (FMSA) Due Date: May 19, 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: Texas Children’s Health Plan (TCHP) would like to make FMSAs aware of a cost survey with an extended due date of May 19,...

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Provider Alert!
23Apr

Provider Alert! Peer to Peer Provider Authorization Communication

Date: April 23, 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 make providers aware of the standard procedures when they receive a peer to peer letter for a denial or a partial denial...

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Provider Alert!
22Apr

Provider Alert! New Provider Type for Non-Local Mental Health Authority Providers of Mental Health Targeted Case Management/Rehab

Date: October 19, 2021 Attention: Billing Services for Behavioral Health Providers (Non-LMHAs) Subject: New Provider Type for Non-Local Mental Health Authority Providers of Mental Health Targeted Case Management/Rehab Deadline for provider enrollment: November 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: Texas Children’s Health...

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