OB/GYNs

Articles with relevant information for OB/GYNs

Provider Alert!
23Mar

Provider Alert! UPDATE: Recent Claim Denials Issued in Error are now Corrected

Date: March 23, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that we have corrected the internal system error that was previously reported. The error impacted claims processing beginning February 27- March 7, 2023. All impacted claims from this time span have been reprocessed. The erroneous EOP message related to these claims was, “This Provider was not certified/eligible to be paid for this procedure/service on this date of service.” Claims impact report: Your assigned...

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22Mar

Provider Alert! Provider Enrollment Revalidation Extensions to End on May 11, 2023

Date: March 21, 2023 Attention: All Providers Call to action: Effective May 11, 2023, the Health and Human Services Commission (HHSC) will end the flexibility of extended Medicaid provider revalidation dates that came due during the COVID-19 public health emergency (PHE). How this impacts providers: Per federal guidance, providers that were due for revalidation effective March 1, 2020, through May 11, 2023, will receive a post-PHE grace period to complete the revalidation process. Texas Medicaid and Healthcare Partnership (TMHP) will notify providers in...

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22Mar

Provider Alert! HHSC Policy Flexibility for Member State Fair Hearings ends on May 11, 2023

Date: March 21, 2023 Attention: All Providers Call to action: The Health and Human Services Commission (HHSC) is ending the additional 30 days a member has to request a fair hearing starting May 12, 2023. For services provided up until May 11, 2023, Texas Children’s Health Plan (TCHP) will allow the additional 30 days. For services provided beginning May 12, 2023, and ongoing, the normal policy of allowing no less than 90 calendar days and no more than 120 calendar days from...

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22Mar

Provider Alert! Federal Public Health Emergency Set to End May 11, 2023 – Update on COVID Flexibilities

Date: March 21, 2023 Attention: All Providers Call to action:  The Health and Human Services Commission (HHSC) has received notice that the COVID-19 federal public health emergency (PHE) declared January 31, 2020, will end on May 11, 2023. In response to the PHE, HHSC implemented certain flexibilities for Texas Children’s Health Plan and other managed care organizations (MCOs) and dental maintenance organizations (DMOs), providers and members, and has issued guidance through MCO Notices with dates to reflect when that guidance is set...

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21Mar

Provider Alert! Reinstatement of CHIP Co-pays for Medical Office Visits

Date: March 20, 2023 Attention: All Providers Effective Date: May 12, 2023 Call to action: In response to the COVID-19 public health emergency (PHE), the Health and Human Services Commission (HHSC) waived co-pays for Children’s Health Insurance Program (CHIP) medical office visits beginning March 13, 2020. HHSC will reinstate co-pays for CHIP medical office visits on May 12, 2023, because the federal PHE ends on May 11, 2023. The reinstatement of medical office visit co-pays does not apply to: COVID-19-related office visits for COVID-19...

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Provider Alert!
10Mar

Provider Alert! Recent Claim Denials Issued in Error are now Being Corrected

Date: March 10, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) is currently addressing recent claim denials that originated from an internal system error. How this impacts providers: No action is required by Providers. TCHP is working diligently to have the system corrected and will reprocess all impacted claims that denied in error by March 24, 2023. The EOP Message for impacted claims: This Provider was not certified/eligible to be paid for this procedure/service on this date of service. Next...

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Provider Alert!
09Mar

Provider Alert! You’re Invited to Our Provider Advisory Group!

Date: March 9, 2023 Attention: All Providers Event dates for the upcoming sessions are based on Service Delivery Area: Thursday, March 23, 2023 Northeast SDA Tuesday, March 28, 2023 Jefferson SDA Thursday, March 30, 2023 Harris SDA All sessions will be from 6:00-7:30PM CST Call to action: Texas Children’s Health Plan (TCHP) invites you to join our quarterly Provider Advisory Group (PAG). We will hold our next round of sessions later this month and dates are based on Service Delivery Area as described above. Click...

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Provider Alert!
09Mar

Provider Alert! Texas Children’s Health Plan announces Partnership with ProgenyHealth

Date: March 8, 2023 Attention: All Providers Effective date: June 12, 2023 Call to action: Texas Children’s Health Plan (TCHP) is happy to announce a partnership with ProgenyHealth, a company which specializes in Neonatal Care Management Services to support our Maternal Health Program. This is an exciting opportunity to partner with our providers for optimal neonatal intensive care unit (NICU) care and enhanced service to our members after NICU discharge through the first year of life. This partnership with ProgenyHealth will support our...

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Provider Alert!
08Mar

Provider Alert! Claims Editing System Reminder

Date: March 8, 2023 Attention: All Providers Call to action: As a reminder, providers are required to bill following the guidance of the CMS and Texas Health and Human Services guidelines. All providers should stay current with these guidelines. Medicaid National Correct Coding Initiative (NCCI) edits may be found at: https://www.medicaid.gov/medicaid/program-integrity/ncci/edit-files/index.html Next steps for providers: Providers should share this communication with their billing staff and confirm that their claims processing systems are configured correctly according to the guidelines provided in the links above. If...

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Provider Alert!
03Mar

Provider Alert! Provider Enrollment and Management System (PEMS) Master Provider File Launch Date has been Postponed

Date: March 1, 2023Attention: All Providers 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 the launch date for the Provider Enrollment and Management System (PEMS) Master Provider File (MPF) and decommissioning of the...

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