News Blog
17Apr

April is National Autism Awareness Month

Autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. Individuals with autism have difficulty interacting with others: building relationships, using language, regulating their emotions, and understanding others’ points of view. The reported prevalence of ASD has been higher in recent years, and this trend is consistent across data sources. Statistics: About 1 in 54 children were identified with autism spectrum disorder among a 2016 sample of 8 year olds from 11 US communities in...

By Events, OB/GYNs, Office Managers, Primary Care Providers, Specialists, 0 CommentsRead more...
17Apr

April is Sexually Transmitted Disease (STD) Awareness month

April is Sexually Transmitted Disease (STD) Awareness month. Cases of sexually transmitted diseases continue to increase in the U.S. The CDC’s new estimates show that there are about 20 million new infections in the United States each year, costing the American health care system nearly $16 billion in direct medical costs (cdc.gov). Because many cases of STDs go undiagnosed—and some common viral infections, such as human papillomavirus (HPV) and genital herpes, are not reported to the CDC at all—the reported...

By OB/GYNs, Office Managers, Primary Care Providers, Specialists, , , 0 CommentsRead more...
Provider Alert!
15Apr

Provider Alert! Second Quarter National Correct Coding Initiative updates

Call to action: Texas Children’s Health Plan (TCHP) supports the National Correct Coding Initiative (NCCI) updates that are implemented for claims processing by TMHP for Texas Medicaid. How this impacts providers: For Health and Behavior Assessment and Intervention (HBAI), codes 96170 and 96171 will no longer be reimbursed after April 1, 2020. Procedure codes 96167 and 96168 will be the only codes for HBAI, which include the member’s family,  that may be reimbursed when the family member directly participates in the...

By Specialists, , , 0 CommentsRead more...
14Apr

COVID-19 Disaster Declaration – ALERT #4 – Prior Authorization Adjustments

Attention: All Provider Notice Effective Date: April 13, 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: As are result of the COVID-19 Disaster Declaration, TCHP has instituted the following changes to our authorization procedures. This alert is an update to our alert on April 2,...

By Primary Care Providers, Provider Alert, , 0 CommentsRead more...
Provider Alert!
08Apr

Provider Alert! FDA removing all ranitidine products from the market

Attention: All Providers and Pharmacies Effective Date: April 2, 2020 Call to action: The FDA announced it is requesting manufacturers withdraw all prescription and over-the-counter (OTC) ranitidine drugs from the market immediately. This is the latest step in an ongoing investigation of a contaminant known as N-Nitrosodimethylamine (NDMA) in ranitidine medications (commonly known by the brand name Zantac). The agency has determined that the impurity in some ranitidine products increases over time and when stored at higher than room temperatures and may result in...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
08Apr

Provider Alert! Provider resources: Coronavirus Aid Relief and Economic Security (CARES) ACT and more

Attention: All Providers Effective Date: March 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: TCHP sincerely appreciates the care you and your staff deliver to our members and want you to know that we are here to provide guidance and support to you...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
07Apr

Provider Alert! COVID-19 Disaster Declaration – ALERT #3 – Prior Authorization Adjustments

Attention: All Providers Effective Date: April 3, 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: As are result of the COVID-19 Disaster Declaration, TCHP has instituted the following changes to our authorization procedures. This alert is an update to our alert on April 2, 2020...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
Provider Alert!
06Apr

Provider Alert! Attention: Early Childhood Intervention (ECI) Providers

Attention: Early Childhood Intervention (ECI) Providers Effective Date: April 3, 2020 Call to action: In accordance with guidance from Texas Medicaid Provider Procedures Manual (TMPPM), providers must use the associated benefit code when submitting claims. How this impacts providers: Changes in billing practices may be required if there are claim denials. Next steps for providers: Billing reminders: Providers should ensure that their claims submissions include their benefit code per TMHP guidelines. If the taxonomy code is attested to a benefit code, the benefit code should be...

By Provider Alert, Specialists, , , , 0 CommentsRead more...
Provider Alert!
03Apr

Provider Alert! Patient Lifts

Attention: Primary Care and DME Providers Effective Date: July 3, 2020 Call to action: In accordance with Texas Medicaid Provider Procedure Manual (TMPPM), patient lifts will require prior authorization, except for E0637 & E0641when billed outside of the benefit limitations.  Click here for the Prior Authorization Form. Coding information for lifts as an addition to the mobility aids that are already on the Prior Authorization list. Code Explanation E0630* Hydraulic//mechanical lift. This code has a limit of 1 purchase every 5 years and 1 month rental. E0635* Portable lift....

By Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
03Apr

Provider Alert! COVID-19 Guidance: UPDATE ALERT #5 Telehealth Services: Targeted Case Management through remote delivery

Attention: Behavioral Health, OB/GYN, and ECI Providers Effective Date: April 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:  TCHP supports Texas Medicaid Healthcare Partnership (TMHP) guidance on Targeted Case Management. This service may be delivered through synchronous audio-visual technologies or telephone (audio-only). Providers should...

By OB/GYNs, Provider Alert, Specialists, , , , , , 0 CommentsRead more...