OB/GYNs

Articles with relevant information for OB/GYNs

May is Mental Health Awareness Month

May is Mental Health Awareness Month Year after year, more and more Americans face the reality of living with a mental illness. Despite their age, many young children show early signs of mental illness. These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors. “Half of all mental health disorders show first signs before a person turns 14 years old, and three quarters of mental health disorders begin [...]

The new and improved Provider Portal is here!

The upgraded Texas Children’s Health Plan Provider Portal is now live! We have worked to bring a revamped user experience to our entire provider network. Our goal is to empower our providers with the tools to access accurate, timely data, so that they are able to deliver the best possible care to our members and their families. The redesigned portal features: Improved functionality for the claims, appeals, and messaging center Health Management Tools menu Access to Healthcare Effectiveness Data and Information Set (HEDIS®) [...]

Provider Alert! Texas Children’s Health Plan Claim Editing System Update

Attention:  All Providers Reminder: Texas Children’s Health Plan Claim Editing System Update   Texas Children’s Health Plan (TCHP) previously sent a Provider Alert notifying providers that an intended transition to a new Claims Editing System (CES) by Optum was to occur in December 2018. Please be advised that this transition will now be occurring May 31, 2019.  Any claims submitted May 31, 2019 and after, including corrected and adjusted claims, will be processed with the Optum CES edits. TCHP is required by Texas [...]

Appointment Availability Standards

Appointment availability standards What are appointment availability standards? How do you as a provider with Texas Children’s Health Plan play a role? In 2015 Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines.                                                 AFTER HOURS: Primary Care Physicians who are accessible 24 hours a day, seven [...]

Texas Children’s Health Plan partners with Baylor College of Medicine to address and prevent opioid abuse in perinatal populations

Women of childbearing age have been disproportionately impacted by the opioid epidemic. Consequently, the rates of in utero drug exposure and Neonatal Abstinence Syndrome have increased dramatically over the last decade.  In Texas, overdose is the leading cause of maternal death in the first postpartum year. To prevent and respond to these issues, faculty from Baylor College of Medicine and Texas Children’s Health Plan were recently awarded funding from the Office of National Drug Control Policy’s grant program entitled Combating [...]

Prior Authorization Reference Information

The Texas Children’s Health Plan website now has an additional resource for information related to prior authorization requirements. The Prior Authorization Reference Information documents the codes that require authorization for payment based on authorization category. This list is not yet all-inclusive. It can be found at: https://www.texaschildrenshealthplan.org/sites/default/files/pdf/PA%20Code%20List%20December%202018.pdf In addition, providers can submit an authorization request online for the codes listed on the Prior Authorization Reference Information document via Clear Coverage. For access to or training on the use of Clear [...]

Smoking cessation help available for parents and caregivers

Smoke-free homes lead to better health outcomes and reduced ED admissions for patients with asthma. Texas Children’s Health Plan provides free smoking cessation counseling and up to $75 of nicotine replacement products for the parents and caregivers of members with asthma. As a provider, you can help your patients more by supporting smoking cessation for parents and caregivers. If your practice site is interested in learning how to enroll parents/caregivers in this program, please contact Texas Children’s Health Plan’s [...]

Texas Children’s Health Plan partners with Baylor College of Medicine to address and prevent opioid abuse in perinatal populations

Women of childbearing age have been disproportionately impacted by the opioid epidemic. Consequently, the rates of in utero drug exposure and Neonatal Abstinence Syndrome have increased dramatically over the last decade.  In Texas, overdose is the leading cause of maternal death in the first postpartum year. To prevent and respond to these issues, faculty from Baylor College of Medicine and Texas Children’s Health Plan were recently awarded funding from the Office of National Drug Control Policy’s grant program entitled Combating [...]

Telemedicine support now available

Texas Children's Health Plan supports the delivery of telemedicine, telehealth and telemonitoring services to its members. Telemedicine and telehealth services should be provided in compliance with standards established by the respective licensing or certifying board of the professional providing the services. Telemedicine and telehealth services do not require authorization when provided by an in-network provider, except in the case of telemonitoring services. Of note, Texas Children’s Health Plan will not cover telemedicine or telehealth services that are provided through only synchronous [...]