Facilities – The Checkup

01 Oct

Provider Alerts – EVV Usage Compliance Review Grace Period Extended

Date: October 1, 2021 Attention: Consumer Directed Services Employers New Compliance Review Due Date: August 31, 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 requires Electronic Visit Verification for all Medicaid personal care services, including services managed through the Consumer Directed Services (CDS) [...]

By Texas Children's Health Plan Facilities, Provider Alert hhsc, EVV, Compliance, CDS 0 Comments Read more...

24 Sep

Provider Alert! Rural Hospitals Outpatient Ratio of Cost to Charges update

Date: September 20, 2021 Attention: Rural Hospitals Effective Date: September 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: The Health and Human Services Commission (HHSC) increased the Rural Hospitals Outpatient Ratio of Cost to Charges (RCC) effective for dates of service September 1, [...]

By Texas Children's Health Plan Facilities, Provider Alert hhsc, tmhp, rural hospitals, rural, outpatient care, RCC 0 Comments Read more...

24 Sep

Provider Alert! Chantix (Varenicline) Tablets Voluntary Recall

Date: September 22, 2021 Attention: All Providers and Pharmacies Effective Date: September 16, 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: Pfizer has issued a voluntary recall of all lots of CHANTIX (Varenicline) Tablets. Potentially impacted customers were notified with a recommendation to not [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert provider alert, Drugs, smoking, Recall, pfizer, chantix 0 Comments Read more...

21 Sep

Provider Alert! Provider Claims Appeal Report now offers a Status Update on the Provider Portal

Date: September 20, 2021 Attention: All Providers Effective Date: September 9, 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: A new enhancement for the provider portal claims appeal report includes a status update for appeals submitted September 9, 2021 or later. How this impacts providers: [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert provider alert, claims, Provider Portal, Claims Appeals 0 Comments Read more...

17 Sep

Provider Alert! COVID-19 Monoclonal Antibody Therapy Procedure Code Update

Date: September 20, 2021 Attention: All Providers Subject: COVID-19 Monoclonal Antibody Therapy Procedure Code Update Effective Date for procedure code M0243 is July 30, 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 that Texas Medicaid [...]

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

03 Aug

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: July 30, 2021 Attention: All Providers Effective Date: July 29, 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: The Texas Vendor Drug Program (VDP) implemented changes to the state Medicaid drug formulary, effective Thursday, July 29, 2021. Select medications moved from “preferred” to [...]

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

27 Jul

Provider Alert! Prior authorization Updates

Date: July 23, 2021 Attention: All Providers Effective Dates: August 1, 2021 and 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: Services no longer requiring a prior authorization effective August 1, 2021 include the following: Biofeedback Codes 90901, 90912, and 90913 Durable Medical Equipment [...]

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

02 Jul

Provider Alert! Reimbursement and Audit Notification on Surgical Procedure Codes (last updated July 1, 2021)

Date: July 1, 2021 Attention: All Providers Subject: 2021-2022 Reimbursement and Audit Notification on Surgical Procedure Codes (last updated July 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 (TCHP) would like to provide information to providers that TCHP follows [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Facilities, Provider Alert provider alert, reimbursement, surgical procedure codes 0 Comments Read more...

24 Jun

Provider Alert! MDCP Minor Home Modification Services Available through the CDS option

Date: June 23, 2021 Attention: FMSA Providers Effective Date: December 1, 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: Effective December 1, 2020, Medically Dependent Children Program (MDCP), minor home modifications services are available through the Consumer Directed Services (CDS) option. How this impacts providers: [...]

By Texas Children's Health Plan Specialists, Facilities, Provider Alert provider alert, MDCP, FMSA, CDS, ADA, Minor Home Modifications, MHM 0 Comments Read more...

21 Jun

Provider Alert! MANDATORY HHSC Webinar Training

Date: June 18, 2021 Attention: Financial Management Services Agencies (FMSA) Webinar Training Date: June 29, 2021 Call to action: Health and Human Services Commission (HHSC) is providing a webinar for Financial Management Services Agencies (FMSAs) scheduled for Tuesday, June 29, 2021, beginning at 1:30 P.M until 3:00 P.M. How this impacts providers: All FMSAs currently contracted with MCOs or HHSC must attend this training. Next steps for providers: FMSA providers should register for the training at: Register now for the FMSA Webinar or texaschildrenshealthplan.or/for-providers/provider-events. Submit specific questions [...]

By Texas Children's Health Plan Office Managers, Facilities, Provider Alert provider alert, hhsc, training, EVV, webinar, FMSA, CDS 0 Comments Read more...