Facilities – The Checkup

22 Jun

Provider Alert! Epidiolex Clinical Prior Authorization Criteria Update

Date: June 21, 2022 Attention: All Providers Effective Date: August 1, 2022 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert Epidiolex, epilepsy 0 Comments Read more...

17 Jun

Provider Alert! Treatment Indications to Change for Ferric Carboxymaltose

Date: June 17, 2022 Attention: All Providers Effective Date: July 1, 2022 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert Ferric Carboxymaltose, iron, kidney 0 Comments Read more...

15 Jun

Provider Alert! Prior authorization criteria for Voxzogo (Vosoritide)

Date: June 15, 2022 Attention: All Providers Subject: Prior authorization criteria for Voxzogo (Vosoritide) Effective Date: July 15, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 July 15, 2022, Texas Children’s Health Plan (TCHP) will implement the Voxzogo clinical edit in-line with the Health [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert Prior Authorization, Voxzogo, Vosoritide, achrondroplasia, epiphyses 0 Comments Read more...

15 Jun

Provider Alert! Respiratory Syncytial Virus (RSV) Prophylaxis Season Reopening in All Regions

Date: June 15, 2022 Attention: All Providers Subject: Respiratory Syncytial Virus (RSV) Prophylaxis Season Reopening in All Regions Effective Date: June 1, 2022 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 Health and Human Services [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert RSV, Synagis, Respiratory Syncytial Virus, Prophylaxis 0 Comments Read more...

15 Jun

Provider Alert! Prior Authorization Criteria Update for Aduhelm Begins July 1

Date: June 15, 2022 Attention: All Providers Subject: Prior Authorization Criteria Update for Aduhelm Begins July 1 Effective Date: July 1, 2022 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 Health and Human Services [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert Prior Authorization, Aduhelm, ARIA, amyloid, imaging, abnormalities 0 Comments Read more...

13 Jun

Provider Alert! Vesta Windows Ends Aug. 31, 2022

Date: June 10, 2022 Attention: All Providers Effective Date: August 31, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 notify program providers, Financial Management Services Agencies, and Consumer Directed Services employers using DataLogic Vesta Windows that [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert FMSA, CDS, DataLogic 0 Comments Read more...

13 Jun

Provider Alert! TMPPM Update for Monoclonal Antibodies Benralizumab, Mepolizumab, and Reslizumab

Date: May 24, 2022 Attention: All Providers Effective Date: April 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 April 1, 2022, Texas Medicaid & Healthcare Partnership (TMHP) will update the Texas Medicaid Provider Procedures Manual, Outpatient Drug Services Handbook section 7.57.5, “Prior Authorization for [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert COVID, COVID-19, monoclonal antibodies 0 Comments Read more...

02 Jun

Provider Alert! June 2022 TMPPM Procedure Code Updates

table { border-collapse: collapse; }tr,td { border: solid thin; } Date: June 1, 2022 Attention: All Providers Effective Date: June 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 Health and Human [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert Procedure Codes, Outpatient, TMPPM, Outpatient Drug Services Handbook 0 Comments Read more...

02 Jun

Provider Alert! Prior Authorization Criteria Updates for Yescarta and Tecartus

Date: June 1, 2022 Attention: All Providers Effective Date: July 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 Health and Human Services Commission (HHSC) will update prior authorization criteria for Yescarta [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert Prior Authorization, cancer, lymphoma, leukemia, tecartus, yescarta, ALL 0 Comments Read more...

02 Jun

Provider Alert! Booster Dose Moderna COVID-19 Vaccine for Adults Added to the Formulary

table { border-collapse: collapse; }tr,td { border: solid thin; } Date: May 31, 2022 Attention: All Providers Effective Date: May 13, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 U.S. Food and Drug [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert Formulary, vaccine, COVID, COVID-19, Booster, moderna 0 Comments Read more...