OB/GYNs

Articles with relevant information for OB/GYNs

Reminder: Tdap Vaccine Coverage for CHIP Perinatal Members

This reminder is to ensure that all providers are knowledgeable on which vaccines are covered for CHIP Perinatal (CHIP-P) members. Based on guidance from the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), and American College of Obstetricians and Gynecologists (ACOG), the Tetanus, Diphtheria, and Acellular Pertussis (Tdap) vaccine is routine prenatal care and is covered in CHIP-P. As noted in the ACOG committee opinion: “The overwhelming majority of morbidity and mortality attributable to pertussis infection occurs [...]

Provider Alert! TCHP Prior Authorization Requirement

Effective January 1, 2019, TCHP will be updating 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 the [...]

CDC data release shows STD diagnoses at record high in U.S.

CDC data release shows STD diagnoses at record high in U.S. The CDC has released preliminary surveillance data presented at the 2018 STD Prevention Conference in Washington, D.C. Data analysis of the five year trend of sexually transmitted diseases (STDs) showed a sharp increase in STDs for four consecutive years (see chart). In 2017, almost 2.3 million cases of chlamydia, gonorrhea and syphilis were reported to the CDC, an increase of more than 200,000 cases from 2016 (see graph). Young women [...]

Texas Children’s Health plan provider and member portals

As a Texas Children’s Health Plan provider, you have access to the Texas Children’s Health Plan provider portal, called TouCHPoint. This portal can be used to check member eligibility, benefits, primary care provider selection, and claims status. To access Provider TouCHPoint, just log on to TexasChildrensHealthPlan.org/for-providers and find the TouCHPoint log-in on the right-hand side of the web page. Texas Children’s Health Plan members can access their own portal at TexasChildrensHealthPlan.org/for-members. The Member Portal allows your patients to play an [...]

Authorization and Verification Process Updates

Authorization and Verification Process Updates                                   Texas Children’s Health Plan has made updates to the authorization process. Individual Member Fax Requests To ensure Health Insurance Portability and Accountability Act (HIPAA) compliance, providers must send one fax request per member with each fax having its own cover sheet. Requests received with multiple members per fax will be returned to the provider and not processed. Minimum Information Required to Process a Request Providers must use the Texas Standard Prior Authorization Request Form*, which can be found [...]

Improving Postpartum Hospital Discharge Education

In September 2018, the Texas Maternal Mortality and Morbidity Task Force released its latest report on deaths occurring during pregnancy and up to 1 year following the end of pregnancy.  Approximately 20% of maternal deaths occurred while the mother was pregnant or during the first 7 days after delivery!  Detailed maternal death case reviews revealed that “inadequate knowledge and lack of early recognition of postpartum complication signs frequently contributed to death.”1 Recommendations by the Task Force included that improvements be [...]

Updating Texas Children’s Health Plan Member Change of Address Information

All address changes must be reported to HHSC. Members can contact HHSC by calling 2-1-1 or by updating their account on YourTexasBenefits.com. It is important to make sure address information is updated in a timely manner to ensure families continue to receive information from Texas Children’s Health Plan and HHSC. If a member has moved to an area that is not covered by Texas Children’s Health Plan, they will need to select a new health plan. If a family [...]

Breaking Reminder: Syphilis Screening Urged for All Pregnant Women

The number of congenital syphilis cases is rising at an alarming rate.  From 2012-2016 the rate of congenital syphilis increased by 87% (from 8.4 to 15.7 cases per 100,000 live births).1   According to historical data, up to 40% of pregnancies with untreated syphilis will result in miscarriage, stillbirth, or infant death.  And those infants who live are at risk for skeletal abnormalities; hepatosplenomegaly; jaundice; anemia; and other complications which can cause developmental delays and seizures.2   Given that congenital syphilis [...]

Texas Children’s Health Plan Provider and Member Portals

As a Texas Children’s Health Plan provider, you have access to the Texas Children’s Health Plan provider portal, called TouCHPoint. This portal can be used to check member eligibility, benefits, primary care provider selection, and claims status. To access Provider TouCHPoint, just log on to TexasChildrensHealthPlan.org/for-providers and find the TouCHPoint log-in on the right-hand side of the web page. Texas Children’s Health Plan members can access their own portal at TexasChildrensHealthPlan.org/for-members. The Member Portal allows your patients to play an [...]

October 11 is National Depression Screening Day

National Depression Screening Day is held annually in October. Depression is the leading cause of disability in the U.S. for ages 15-44. It is estimated that up to 64% of youth with major depressive disorder do not receive mental health treatment. Depression in youth has been linked to school and behavioral problems, self-injury and suicide, and poor social functioning. The incidence of perinatal depression ranges from 5 to 25 percent of pregnant and postpartum women, and studies of low-income [...]