Facilities

Articles with relevant information about Facilities.

Provider Alert! Anywhere Care (Telemedicine): How to become a participating provider

Attention: All Providers Effective Date: March 20, 2020 In order to reduce exposure to the Coronavirus Disease (COVID-19) and slow the spread of the illness, Texas Children’s Health Plan is promoting the use of Telemedicine, a covered benefit. We hope you are able to adapt your practice to delivering care via telemedicine. An increased use of telemedicine services will result in three immediate benefits: Preventing emergency rooms from being overcrowded. Limiting exposure among health care workers to infected individuals. Lessening the use of masks, gowns [...]

Provider Alert! COVID-19 Disaster Declaration – Texas Children’s Health Plan Operational Adjustments

Attention: All Providers Effective Date: March 13, 2020 TCHP affiliated providers should monitor the 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.   Reporting adjustments to normal provider business operations Texas Children’s Health Plan has developed a provider notification survey which is posted on the Provider portal www.texaschildrenshealthplan.org/for-providers and the website. This survey allows providers to self-report [...]

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

Attention: All Providers Effective Date: March 18, 2020 TCHP affiliated providers should monitor the 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.   As a result of the COVID-19 Disaster Declaration, TCHP has instituted the following:   In order to increase access to primary care services, TCHP is now waiving prior authorization requirements for out-of-network primary care visits [...]

Provider Alert! Update – Telemedicine & Telehealth Services and COVID-19

Attention: All Providers Effective Date: March 17, 2020 Texas Children’s Health Plan supports the delivery of telemedicine and telehealth services to its members. As part of our COVID-19 Emergency Response, Texas Children’s Health Plan will add coverage of telemedicine services that are provided through only synchronous audio interactions (audio-only telephone consultation). How this impacts providers: Telemedicine services should be provided in compliance with standards established by the respective licensing or certifying board of the professional providing the services. While telemedicine services do not [...]

Provider Alert!

Provider Alert! Prior Authorization Alert

Effective January 1, 2019, Texas Children’s Health Plan updated the prior authorization listing. Please note there are some key changes for providers. Removed from the list and will no longer require prior authorization: Baclofen Pump New to the list: Home Telemonitoring Updates: Ambulance (non-emergent transport) has been updated to Non-Emergency Ambulance Transport. Augmentative Communication Device has been updated to Augmentative Communication Device and Accessories. Chemotherapy non-FDA approved has been updated to Non-FDA approved medications. Cranial Molding Orthosis (Helmets) has been updated to Cranial Molding Orthosis. High cost (>$50,000) injectable in [...]

Hospital – Facility Billing Neonatal Claims Must Submit Application for Neonatal Level of Designation before July 1, 2018

Attention:  All Hospitals Subject:  Hospitals Billing Neonatal Claims Must Submit Application for Neonatal Level of Designation before July 1, 2018 Effective immediately, hospitals rendering neonatal services must submit their neonatal designation applications to the Texas Department of State Health Services. Completed applications must be submitted before July 1, 2018. Applications received after July 1 will not be considered for approval. If an application is received after July 1, it will not be considered as submitted in time for approval by the executive commissioner [...]

Provider Alert!

Provider Alert! Uniform Hospital Rate Increase Program (UHRIP)

Attn: STAR HOSPITAL SERVICES RE: Uniform Hospital Rate Increase Program (UHRIP) Dear Provider, The Texas Health and Human Services Commission (HHSC) has received approval from the Centers for Medicare and Medicaid Services to implement the Uniform Hospital Rate Increase Program (UHRIP) for hospital services effective March 1, 2018 for Harris and Jefferson Service Delivery Areas (SDAs).  State-owned hospitals and institutions for mental diseases are excluded from the program. Texas Children’s Health Plan (TCHP) will be sending a Letter of Agreement to all eligible [...]

Upcoming Electronic Visit Verification (EVV) training sessions

Houston Date: November 7 & 8, 2017 The same information will be covered on both days, so providers only need to attend one session. Time: 9:00am – 4:00pm Location: Texas Children’s Hospital, The Woodlands Campus, 17580 Interstate 45 South, The Woodlands, TX 77384   Irving When: December 5 & 6, 2017 The same information will be covered on both days, so providers only need to attend one session. Time: 9:00am – 4:00pm Location: The Innovator’s Auditorium, 1660 N Westridge Drive Irving, TX 75038   Click here for more information

Notice to Prescribers: Mosquito Repellent Benefit

Texas covers select mosquito repellents for the prevention of Zika virus. The following notice describes how clients may access mosquito repellent through Medicaid and other state programs, and provides essential information for prescribers regarding the mosquito repellent benefit. Covered programs: Medicaid (managed care, MCO; and fee-for-service, FFS) AND Children's Health Insurance Program (CHIP) and CHIP-Perinatal Healthy Texas Women Children with Special Health Care Needs Services Program (CSHCN) Family Planning Program 1. Medicaid (FFS and MCO) and CHIP Clients The Texas Medicaid Medical Director has issued a Texas Medicaid [...]

TCHP now accepts Outpatient Authorizations for many services online via Clear Coverage effective June 1, 2017!

Tired of faxing authorization requests and medical records? Spending too much time on hold waiting to speak to an Authorization Specialist for non-urgent authorization request? Looking for a faster, more efficient way to submit authorizations? Why not submit your authorizations request through Clear Coverage? What are the benefits? Easy to access 24/7 online access to Clear Coverage Receive real time authorization status by viewing your office’s home page in Clear Coverage Services are immediately uploaded into Texas Children’s Health Plan’s authorization for clinical review Automatic APPROVALS may [...]