OB/GYNs

Articles with relevant information for OB/GYNs

Provider Alert!
17Jul

Provider Alert! Prenatal Dental Care Information

Date: July 13, 2023 Attention: Ob-Gyn Providers Call to action: Texas Children’s Health Plan (TCHP) would like to remind OB-Gyn providers about the availability of dental benefits for pregnant Medicaid members. The CDC and ACOG both recommend routine dental care during pregnancy, but TCHP has noted a limited number of pregnant women are familiar with dental benefits. Routine dental care during pregnancy is safe and can improve maternal oral health, decreasing future dental issues for the mother and improving oral health for...

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Provider Alert!
13Jul

Provider Alert! No-cost sports and school physicals for CHIP and Medicaid patients

Date: July 13, 2023 Attention: Primary Care Providers, OB/GYNs, and Office Managers Call to action:  It will soon be back-to-school season, which means your patients will need to complete their annual sports and school physicals. As part of the Healthy Rewards Program*, Texas Children’s’ Health Plan CHIP, STAR and STAR Kids members ages 5 to 19 years** can receive a no-cost sports and school physical. A Texas Health Steps or well-child visit within the last 12 months is required. Members should bring...

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Provider Alert!
13Jul

Provider Alert! Signature Updates to Home Health Prior Authorization Request Forms

Date: July 12, 2023 Attention: All Providers Effective date: July 1, 2023 Call to action: The purpose of this communication is to provide awareness that the signature requirements for Title XIX (Medicaid) Home Health Services have changed. Medicaid-enrolled physicians and allowed practitioners can now sign prior authorizations and order covered Medicaid Home Health Services, including skilled nursing, home health aide services, durable medical equipment and supplies, and adult physical and occupational therapy services. An allowed practitioner is a physician assistant (PA) or an advanced...

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Provider Alert!
13Jul

Provider Alert! Clinical Criteria for Tzield® (procedure code J9381) effective August 1, 2023

Date: July 11, 2023 Attention: All Providers Effective Date: August 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective August 1, 2023, the Texas Health and Human Services (HHSC) will be implementing prior authorization criteria for Tzield ® (procedure code J9381). The approval duration will be for the 14-day treatment. Tzield is the first-in-class therapy indicated to delay the onset of Stage 3 Type 1 diabetes (T1D) in adults and pediatric patients 8 years...

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Provider Alert!
07Jul

Provider Alert! Noninvasive Prenatal Screening Benefits to Change for Texas Medicaid July 1, 2023

Date: July 7, 2023 Attention: All Providers Effective Date: July 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective July 1, 2023, noninvasive prenatal screening (NIPS) benefits will change for Texas Medicaid. How this impacts providers: Effective July 1, 2023, major changes to this medical benefit include the following: Updated benefit eligibility criteria Removed fee-for-service (FFS) prior authorization requirement NIPS is a benefit for members who have a confirmed intrauterine singleton pregnancy dated at least ten weeks gestation. Members...

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Provider Alert!
23Jun

Provider Alert Texas Health Steps Dental Services Reminder

Date: June 23, 2023 Attention: Primary Care Providers Call to action: Due to an increase in the number of TCHP members utilizing emergency services for dental-related visits, we would like to remind providers of the importance and availability of preventive dental care for children receiving Texas Health Steps services. Additionally, almost 23 percent of US children ages 2 through 5 have experienced dental caries in primary teeth, highlighting the need for early preventive services. Early childhood cavities are the most common chronic...

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Provider Alert!
22Jun

Provider Alert! New Fax Line for Post Hospital Discharge Authorizations

Date: June 22, 2023 Attention: All Providers Effective date: July 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers of a recent update to the prior authorization fax lines. On July 1, 2023, a new line will be added. This fax line will be used to send in authorization requests for members who are hospitalized at the time of request and services or equipment that are necessary for care of the member immediately after discharge. Requests unrelated to discharge...

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Provider Alert!
20Jun

Provider Alert! HHSC to Add New Qulipta® Indication to Clinical Prior Authorization

Date: June 20, 2023 Attention: All Providers Effective Date: June 27, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective June 27, 2023, Texas Health and Human Services (HHSC) will follow the Food and Drug Administration’s recent approval of new indication for atogepant (Qulipta®), to prevent chronic migraine in adults. How this impacts providers: Starting June 27, 2023, TCHP will implement the new indication for atogepant (Qulipta®) to prevent chronic migraine in adults. The new criteria...

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Provider Alert!
20Jun

Provider Alert! Prior Authorization Diagnosis Coding Reminder

Date: June 20, 2023 Attention: All Providers Call to action: As a reminder, Texas Children’s Health Plan (TCHP) aligns with the Texas Medicaid Provider Procedure Manual (TMPPM) regarding the ICD-10-CM diagnosis-coding requirement on claim submissions. Resource: TMPPM Section 6: Claims filing How this impacts providers: Diagnosis codes guidance as outlined in the TMPPM are as follows: Diagnosis codes must be to the highest level of specificity available Diagnosis codes must be appropriate for the age of the client as identified in the ICD-10-CM description of the...

By HHSC, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
14Jun

Provider Alert! Member Eligibility Verification Methods and Information on Medicaid Billing!

Date: June 14, 2023 Attention: All Providers Member eligibility information: Texas Children’s Health Plan (TCHP) would like to remind providers that the Medicaid and/or CHIP coverage rules changed, beginning April 1, 2023. This means that some of our members will need to go through the process to determine their eligibility for coverage. Our members will be required to renew their Medicaid and/or CHIP coverage or risk losing their plan and access to healthcare. TCHP has actively communicated with members about this change...

By Facilities, HHSC, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...