OB/GYNs – The Checkup

Articles with relevant information for OB/GYNs

29 Oct

Provider Alert! 2021 Evaluation and Management (E/M) Guideline Changes

Attention: All Providers Effective Date: January 1, 2021 Call to action: Evaluation and Management (E/M) Guidelines for new and established patient office visits and other outpatient services have gone through substantial revisions by the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS). These changes are effective on January 1, 2021 and only affect the new and established patient office visits and outpatient codes (CPT 99201 – 99215). Code 99201 will be eliminated. The History and Physical Examination are no longer [...]

By tcph Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert Evaluation and Management, E/M 0 Comments Read more...

29 Oct

Provider Alert! Annual Electronic Visit Verification (EVV) Training Webinar

Attention: Current Electronic Visit Verification (EVV) Users Effective Date: 10/29/2020 Call to action: The webinar is for program providers currently required to use electronic visit verification by state law. Attending the webinar helps complete annual EVV policy and EVV Portal training requirements. There will also be a live question and answer session. The training is on November 13, 2020 at 8:30 a.m. – 12:30 p.m. How this impacts providers: Effective August 1, 2020, the Health and Human Services Commission (HHSC) Electronic Visit [...]

By tcph Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert EVV 0 Comments Read more...

28 Oct

Provider Alert! Prior Authorization Guideline updates for TMJ and Skilled Nursing Facility

Attention: All Providers Effective Date: August 25, 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: Texas Children’s Health Plan (TCHP) would like to inform you of recent updates to the prior authorization requirements and the effective dates. The following codes for each service [...]

By tcph Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert Prior Authorization, TMJ, skilled nursing facility 0 Comments Read more...

23 Oct

Provider Alert! Subject: Codes: K0108, A9900, and E1399 Wheelchair Guideline

Attention: All Providers Effective Date: October 22, 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. In follow-up to our Provider Alert posted on 7/13/2020 regarding wheelchair accessories, Texas Children’s Health Plan did not implement changes to the current process for prior authorization of codes: K0108, A9900, and [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert provider alert, provider alerts, Guidelines, wheelchair, Codes, guideline 0 Comments Read more...

23 Oct

Provider Alert! Texas Children’s Health Plan Special Investigations Unit and Claims Payment Review Information

Attention: All Providers Effective Date: October 23, 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: Texas Children’s Health Plan (TCHP) would like to share information with our provider network on two important topics, the Special Investigation Unit and Claims Payment Reviews. What is the [...]

By Texas Children's Health Plan Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert provider alert, claims, provider alerts, siu, special investigations unit, claims payment review 0 Comments Read more...

14 Oct

Provider Alert! Medicaid, STAR Kids, CHIP, and CHIP Perinatal eligibility during COVID-19

Attention: All Providers Effective Date: July 31, 2020 – January 21, 2021 The content in this message will remain in effect through the public health emergency period, extended to January 21, 2021, as announced by the U.S. Health and Human Services Department. TCHP COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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 [...]

By tcph Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert medicaid, CHIP, STAR, COVID 0 Comments Read more...

05 Oct

Provider Alert! Concerta® to return to non-preferred status

table { border-collapse: collapse; }tr,td { border: solid thin; } Attention: All Providers Effective Date: October 16, 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: The Texas Vendor Drug Program (VDP) updated the Texas Medicaid formulary for STAR and STAR Kids members. The branded formulations of [...]

By tcph Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert Pharmacy, concerta 0 Comments Read more...

29 Sep

Provider Alert! Invoices Required for Manually Priced Laboratory Testing Claims Submissions

Attention: Laboratory Providers Effective Date: September 21, 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: Laboratory providers submitting claims for COVID-19 testing or other services for a manually priced test must include the appropriate invoice(s) and documentation to ensure that manually priced laboratory [...]

By tcph Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert Laboratory Testing Claims 0 Comments Read more...

29 Sep

Provider Alert! Limit increased for Code A4628, Oral Suction Catheter

Attention: All Providers Effective Date: September 22, 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: Texas Children’s Health Plan (TCHP) would like to inform providers that effective September 22, 2020 the limit for HCPCS Code A4628, oral suction catheter has been increased from [...]

By tcph Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert Oral suction catheter 0 Comments Read more...

29 Sep

Provider Alert! Prior Authorization Update for Botulinum Toxin Benefits with Diagnosis Restriction

Attention: All Providers Effective Date: October 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: Texas Children’s Health Plan (TCHP) would like to inform providers of an update to the prior authorization requirements for Botulinum Toxin effective October 1, 2020. A prior authorization [...]

By tcph Primary Care Providers, OB/GYNs, Office Managers, Specialists, Provider Alert Prior Authorization, Botulinum 0 Comments Read more...