Office Managers

Articles with relevant information for Office Managers.

Provider Alert! CHIP co-pays waived for office visits in response to COVID-19   

Date: October 26, 2022      Attention: All Providers Effective Date: October 25, 2022  The content in this message will remain in effect through November 30, 2022 as announced by the Health and Human Services Commission. TCHP COVID-19 Utilization Management Procedure and 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 update and/or change this information without prior notice due to the...

Provider Alert!

Provider Alert! Clinical Criteria Update for Orkambi Effective November 9

Date: October 25, 2022 Attention: Providers Effective Date: October 1, 2022 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 Health Plan (TCHP) will revise clinical prior authorization criteria for Orkambi (lumacaftor/ivacaftor) to comply with the recent Food and Drug Administration-approved age indications. How this impacts...

Provider Alerts! Cosentyx Clinical Prior Authorization Criteria Revision Scheduled for November 22

Date: October 25, 2022 Attention: Providers Effective Date: October 1, 2022 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 Health Plan (TCHP) will revise clinical prior authorization criteria for Cosentyx to comply with the recent Food and Drug Administration-approved age indications. How this impacts providers:...

Provider Alert!

Provider Alert! ProAir® HFA Inhaler Discontinuation

Date: October 17, 2022 Attention: All Providers Effective Date: October 1, 2022 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 let providers know that the ProAir® HFA inhaler, one of many preferred asthma inhalers, was discontinued by...

Provider Alert!

Provider Alert! RSV Fall/Winter Traditional Season Regional Changes Begin October 17

Date: October 17, 2022 Attention: All Providers  Effective Date: October 17, 2022 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: Traditional Respiratory Syncytial Virus (RSV) season is here. Texas Children’s Health Plan (TCHP) would like to let providers know that effective October 17, 2022, the Texas...

Provider Alert! COVID-19 Procedure Code Updates for Second Quarter 2022 HCPCS

Date: October 12, 2022 Attention: All Providers Effective Date: June 23, 2022 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 Health Plan (TCHP) would like to inform providers that on June 23, 2022, the Texas Medicaid & Healthcare Partnership (TMHP) implemented the second...

Provider Alert!

Provider Alert! CPT Codes for Vision Testing Reminder

Date: October 12, 2022 Attention: 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: The purpose of this communication is to remind providers about Texas Children’s Health Plan’s (TCHP) Current Procedural Terminology (CPT) codes for vision testing and medically necessary eye examinations. Vision...

Provider Alert!

Provider Alert! September 2022 Specialty Drug List Available

Date: October 11, 2022 Attention: All Providers Effective Date: September 28, 2022 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 September 2022 Biannual Specialty Drug List (SDL) is now available from the vendor drug program website. How this impacts providers: Providers should refer to the vendor...

Provider Alert! Bivalent Pfizer COVID-19 Booster Vaccine Coverage Update

Date: October 12, 2022 Attention: All Providers Effective Date: August 31, 2022 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’s (TCHP) would like to notify providers that on August 31, 2022, the U.S. Food and Drug Administration (FDA) amended the...

Provider Alert! COVID-19 Vaccine Administration Procedure Codes 0124A & 0134A Are Now Benefits for Medicaid & CHIP

Date: October 12, 2022 Attention: All Providers Effective Date: August 31, 2022 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 Health Plan (TCHP) would like to inform providers that effective for dates of service on or after August 31, 2022, in accordance with...