Facilities

Articles with relevant information about Facilities.

Provider Alert!
17Nov

Provider Alert! Timeframe for follow-up from an Inpatient Behavioral Health Facility

Date: November 17, 2023 Attention: Behavioral Health Providers and inpatient facilities Call to action: Texas Children’s Health Plan (TCHP) request that all members receiving inpatient psychiatric services be scheduled prior to discharge for outpatient or lower level of care follow-up with an in network behavioral health provider. To search for TCHP network behavioral health providers, click here. The timeframe requirements are as follows: Initial outpatient treatment after discharge must occur within seven (7) days from the date of discharge. The appointment should not occur...

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Provider Alert!
21Sep

Provider Alert! Billing Updates for Envolve Vision

Date: September 19, 2023 Attention: All Providers Effective Date: October 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to remind you that Envolve Vision provides vision coverage for our CHIP, STAR and STAR Kids members up to 18 years old. For your awareness, Envolve Vision's Clinical Policy for Routine (Preventive) Eye Examination (OC.UM.CP.0013) has recently been updated. The following changes will take effect for claims submitted on or after October 1, 2023: Headache codes R51.0 and R51.9 have been removed from...

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Provider Alert!
29Aug

Provider Alert! Medicaid Re-enrollment: Patients May Risk Losing Their Medicaid Plan!

Date: August 28, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to thank you for supporting your patients with maintaining coverage during the Medicaid re-enrollment currently underway. Background information: As you may know, Medicaid coverage rules have changed, and some Medicaid recipients need to go through the renewal process to determine their eligibility for coverage. This is the result of the Consolidated Appropriations Act, 2023 (CAA, 2023) that was enacted on December 29, 2022. The CAA ended the...

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Provider Alert!
18Aug

Provider Alert! Member Experience Survey Coming Soon

Date: August 17, 2023 Attention: All Providers Effective Date: August 2023 Call to action: Texas Children Health Plan (TCHP) would like to let providers know that later this month your patients may be given a member experience survey. The survey will include questions in regards to, but not limited to, communication, care coordination and access to care. Participation in this survey is voluntary. How this impacts providers: Members’ responses will help create effective, active interventions where we hope to partner with you and better...

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Provider Alert!
16Aug

Provider Alert! Healthy Rewards/Value Added Services for 2023-2024

Date: August 16, 2023 Attention: All Providers Effective Date: September 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) is proud to present our Healthy Rewards Program/Value Added Services (VAS) program effective September 1, 2023 through August 31, 2024. These rewards and services are available in each line of business CHIP, STAR, and STAR Kids and Service Delivery Areas; Harris, Jefferson and North East (limitations may apply). Member favorites, such as the Prenatal and Postpartum Visit Rewards, Portable Crib/Playpen, Diabetes Management Rewards and...

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Provider Alert!
07Aug

Provider Alert! Implementation of Sotyktu Criteria in Cytokine and CAM Antagonists Clinical Prior Authorization

Date: August 4, 2023 Attention: All Providers Effective Date: July, 27 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective July, 27 2023, the Texas Health and Human Services Commission (HHSC) implemented criteria for Sotyktu®. Sotyktu® belongs to the Cytokine and CAM Antagonists class and is indicated for the treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. How this impacts providers: The new criteria is available on the HHSC...

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Provider Alert!
25Jul

Provider Alert! Extensive Case Management Programs Available for Members

Date: July 25, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that extensive case management and service coordination programs are available to our members. In addition, several virtual classes are offered to our members in English and Spanish. Our case managers play an important role in assisting our members with obtaining the necessary medical and/or behavioral health care, support, resources and services they need to achieve the best possible health outcomes.  How this impacts providers:...

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Provider Alert!
25Jul

Provider Alert! TexMedConnect and EVV Portal Access

Date: July 25, 2023 Attention: Home Health Care Services Providers, STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Effective Date: January 1, 2024 Call to action: The Texas Health and Human Services Commission (HHSC) would like to let providers know that Electronic Visit Verification (EVV) will be required for Home Health Care Services (HHCS) as of January 1, 2024. The HHCS required to use EVV are found in the document, Programs, Services and Service Delivery Options Required to Use Electronic Visit Verification by January...

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Provider Alert!
21Jul

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: July 21, 2023 Attention: All Providers Effective Date: July 27, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective July 27, 2023, select medication(s) moved from “preferred” to “non-preferred” status. A summary of the changes is included below. Resource: https://www.txvendordrug.com/formulary/preferred-drugs Changes with biggest impact to Texas Children Health Plan members and providers: The drugs listed below were either not previously reviewed (NR) and became non-preferred (NPD) or previously considered a preferred agent (PDL) but now have changed...

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Provider Alert!
21Jul

Provider Alert! EVV Proprietary System Operator Waitlist is Full

Date: July 20, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Call to action: The Texas Health and Human Services Commission (HHSC) is notifying all program providers and FMSAs that the waitlist to onboard as an EVV Proprietary System Operator (PSO) is full. Program providers or FMSAs on the waitlist as of Friday, June 23, 2023, will participate in the expedited PSO onboarding session planned between July 15 through Aug. 31. How this impacts providers: Program providers and FMSAs who...

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