Office Managers

Articles with relevant information for Office Managers.

Provider Alert!
29Aug

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

Date: August 29, 2023 Attention: All Providers Thursday, September 21, 2023 Northeast SDATuesday, September 26, 2023 Jefferson SDAThursday, September 28, 2023 Harris SDANEW TIME: All sessions will be from 12:00PM (Noon) – 1:30PM 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 next month and dates are based on Service Delivery Area (SDA) as described above. Click here if you are not sure of your SDA....

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Provider Alert!
28Aug

Provider Alert! HHSC to Add Skysona® as Medicaid and CHIP Benefit July 1, 2023, Prior Authorization Effective September 1, 2023

Date: August 24, 2023 Attention: All Providers Effective Date: September 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective September 1, 2023, the Texas Health and Human Services (HHSC) will be implementing required prior authorization criteria for Skysona® (procedure code J3590) for Medicaid and CHIP. Skysona® will become a benefit of Medicaid and CHIP on July 1, 2023. Skysona® (betibeglogene autotemcel) is indicated to slow the progression of neurologic dysfunction in boys 4-17 years...

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Provider Alert!
18Aug

Provider Alert! Member Experience Survey Coming Soon

Date: August 17, 2023 Attention: All Providers Effective Date: August 2023 Call to action: Texas Children Health Plan (TCHP) would like to let providers know that later this month your patients may be given a member experience survey. The survey will include questions in regards to, but not limited to, communication, care coordination and access to care. Participation in this survey is voluntary. How this impacts providers: Members’ responses will help create effective, active interventions where we hope to partner with you and better...

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Provider Alert!
16Aug

Provider Alert! Healthy Rewards/Value Added Services for 2023-2024

Date: August 16, 2023 Attention: All Providers Effective Date: September 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) is proud to present our Healthy Rewards Program/Value Added Services (VAS) program effective September 1, 2023 through August 31, 2024. These rewards and services are available in each line of business CHIP, STAR, and STAR Kids and Service Delivery Areas; Harris, Jefferson and North East (limitations may apply). Member favorites, such as the Prenatal and Postpartum Visit Rewards, Portable Crib/Playpen, Diabetes Management Rewards and...

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07Aug

Provider Alert! UPDATED: COVID-19 Vaccine Counseling Procedure Code G0315 Now a Benefit

Date: August 7, 2023 Attention: All Providers Effective date: Dates of service on or after December 2, 2021 Call to action: Texas Children Health Plan (TCHP) would like to inform providers that effective for dates of service on or after December 2, 2021, COVID-19 vaccine counseling procedure code G0315 is a benefit of Medicaid for individuals birth through 20 years of age. How this impacts providers: Procedure code G0315 will be limited to a maximum of three vaccine counseling services (G0315), per rolling year...

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Provider Alert!
07Aug

Provider Alert! Implementation of Sotyktu Criteria in Cytokine and CAM Antagonists Clinical Prior Authorization

Date: August 4, 2023 Attention: All Providers Effective Date: July, 27 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective July, 27 2023, the Texas Health and Human Services Commission (HHSC) implemented criteria for Sotyktu®. Sotyktu® belongs to the Cytokine and CAM Antagonists class and is indicated for the treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy or phototherapy. How this impacts providers: The new criteria is available on the HHSC...

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Provider Alert!
28Jul

Provider Alert! Update to the Long-Term Services and Supports Billing Matrix and Crosswalk

Date: July 28, 2023 Attention: STAR kids Providers Billing matrix has been updated effective: July 7, 2023 Call to action: The purpose of this communication is to inform providers of updates made to the LTSS billing matrix effective July 7, 2023. Description of the updates:   Health and Human Services Commission (HHSC) added language to clarify that the U6 modifier must be added to all prior authorizations and encounter claims for state plan LTSS for members in the Medically Dependent Children Program (MDCP) HHSC also made corrections to...

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Provider Alert!
25Jul

Provider Alert! Reminder: Patient Access to Mosquito Repellents Available Through Pharmacy

Date: July 25, 2023 Attention: All Providers Call to action: Texas Health and Human Services Commission (HHSC) would like to remind pharmacies and other providers of the mosquito repellent pharmacy benefit. According to a June 26 Centers for Disease Control and Prevention notice, locally acquired malaria cases were identified in Texas. To prevent and control the spread of malaria and other mosquito-borne diseases in Texas, HHSC reminds pharmacies and other providers of the mosquito repellent pharmacy benefit. How this impacts providers: HHSC covers mosquito repellents year-round to...

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Provider Alert!
25Jul

Provider Alert! TexMedConnect and EVV Portal Access

Date: July 25, 2023 Attention: Home Health Care Services Providers, STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Effective Date: January 1, 2024 Call to action: The Texas Health and Human Services Commission (HHSC) would like to let providers know that Electronic Visit Verification (EVV) will be required for Home Health Care Services (HHCS) as of January 1, 2024. The HHCS required to use EVV are found in the document, Programs, Services and Service Delivery Options Required to Use Electronic Visit Verification by January...

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Provider Alert!
21Jul

Provider Alert! Medicaid Preferred Drug List and Formulary Changes

Date: July 21, 2023 Attention: All Providers Effective Date: July 27, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective July 27, 2023, select medication(s) moved from “preferred” to “non-preferred” status. A summary of the changes is included below. Resource: https://www.txvendordrug.com/formulary/preferred-drugs Changes with biggest impact to Texas Children Health Plan members and providers: The drugs listed below were either not previously reviewed (NR) and became non-preferred (NPD) or previously considered a preferred agent (PDL) but now have changed...

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