Facilities – Page 21

Articles with relevant information about Facilities.

01FebFebruary 1, 2018

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 hospitals...

By Texas Children's Health PlanFacilities, HHSC, Provider AlertFax Blast, hhsc, Hospital, STAR, Uniform Hospital Rate Increase Program0 CommentsRead more...

11OctOctober 11, 2017

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

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsEVV, training0 CommentsRead more...

17MayMay 17, 2017

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 be...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsAuthorization, Authorizations, Clear Coverage, Outpatient0 CommentsRead more...

17MayMay 17, 2017

Provider Alert! Authorization Extension for STAR Kids Members

Attention STAR Kids Providers May 17, 2017 Authorization Extension for STAR Kids Members The Health and Human Services Commission expects managed care organizations to extend long term services and supports (such as Personal Care Services, Community First Choice, and Private Duty Nursing) authorizations for services until completion of the STAR Kids Screening and Assessment Instrument (SAI), but no longer than July 1, 2017. In order to receive payment for these services, you must have authorization from Texas Children’s Health Plan, and the SAI must be completed by...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsAuthorizations, provider alert, SAI, Screening and Assessment Instrument0 CommentsRead more...

17MayMay 17, 2017

No Prior Authorizations Required for Texas Children’s Health Plan (TCHP) In-Network Observations

1. In-network Observation stays do not require prior-authorization. 2. Hospital stays that include less than two bed days (less than “two midnights”) at the time of submission will be categorized as Observation Level of Care with some exceptions: a. Obstetrical deliveries b. Patient deaths c. Against Medical Advice (AMA) discharges d. Intensive Care Unit (ICU) admissions e. Pediatric Intensive Care Unit (PICU) admissions f. Pediatric Progressive Care Unit (PCU) g. Initial Neonatal Intensive Care Unit (NICU) admissions h. Neonatal Intensive Care Unit (NICU) readmissions within 28 days i. Behavioral Health...

By Texas Children's Health PlanFacilitiesAdmissions, In-Network, Prior Authorizations, Utilization Management0 CommentsRead more...

01MayMay 1, 2017

Need Help Navigating Pharmacy Prior Authorizations?

Pharmacy Prior Authorizations (PAs) can be a difficult administrative burden for providers and staff, however, they help ensure patients are receiving the most evidence-based, cost-effective medications. The Vendor Drug Program (VDP) is the state resource for the Texas Medicaid formulary and Preferred Drug List (PDL). VDP has provided a very helpful guide to managing pharmacy benefits for your patients. You can access this resource here: http://casestudies.txhealthsteps.com/stepsQuickCourses/prescribers/ This Quick Course reviews the following: Searching Formulary for prescription and OTC drugs Checking the Preferred Drug List...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, SpecialistsPAs, PDL, Pharmacy, Preferred Drug List, Prior Authorizations, Texas Medicaid Formulary, Texas Vendor Drug Program, VDP0 CommentsRead more...

07AprApril 7, 2017

Inpatient Authorization Requests through Clear Coverage

Texas Children’s Health Plan is excited to announce the upcoming implementation of Clear Coverage for inpatient authorization requests beginning May 1, 2017. Clear Coverage is a web-based system that provides an automated method for providers and health plans to manage authorizations for inpatient services at the point of decision. Clear Coverage enables automated authorization, notification, eligibility and direction of members to in-network service providers. Clear Coverage provides the following benefits: Providers have immediate access to coverage, medical appropriateness and network rules,...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsAuthorizations, Clear Coverage, Eligibility, McKesson, Notification0 CommentsRead more...

15MarMarch 15, 2017

Meet Our New President

Lou Fragoso has been appointed president of Texas Children’s Health plan. He joined Texas Children’s Pediatrics in February 2014 and was vice president of Business Operations. Prior to joining Texas Children’s, Lou was in leadership roles at Baylor College of Medicine in Houston and at Lurie Children’s Hospital in Chicago. Lou is a Certified Public Accountant with over 20 years of healthcare finance and management experience. Since joining Texas Children’s Pediatrics, Lou spearheaded the creation of Texas Children’s Urgent Care. Texas...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialistsleadership, president, texas children's health plan0 CommentsRead more...

14MarMarch 14, 2017

New Texas Children’s Health Plan provider portal features added

Texas Children’s Health Plan has been actively adding new features to the provider portal located at www.tchp.us/providers Providers can continue to view eligibility, claim status, authorizations and all of our provider news. In addition, providers are able to view the named Service Coordinator for STAR Kids members and submit claim appeals online. The named Service Coordinator for STAR Kids members can be found on the member enrollment information screen under additional information. The Texas Children’s Health Plan Service Coordinator serves as the...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, SpecialistsAuthorizations, billing, claims, Provider News, Provider Touchpoint, Service Coordinator0 CommentsRead more...

13FebFebruary 13, 2017

What is the role of STAR Kids Service Coordinators?

A Service Coordinator is the central contact between Texas Children’s Health Plan and a member’s providers and family members. The purpose of a Service Coordinator is to maximize a Member’s health, wellbeing and independence. The Service Coordinator must work with the Member’s PCP to coordinate all of a member’s health services. The STAR Kids Service Coordinator also engages as an advocate and intervenes on behalf of the member if approved by the member. The Service Coordinator will perform an overall evaluation...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsAdolescent Transition, Advocacy, medicaid, Service Coordination, Service Coordinators, STAR Kids0 CommentsRead more...