Office Managers

Articles with relevant information for Office Managers.

Provider Alert!
13Oct

Provider Alert! Online Learning Opportunity: Pediatric Brain Health Summit on November 5-6, 2020

Attention: Primary Care Providers, Neurologists, Early Childhood Specialists, and relevant 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 2020 Pediatric Brain Health Summit is being held online November 5-6, 2020. The...

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Provider Alert!
08Oct

Provider Alert! New prior authorization requirements for Burosumab-Twza(Crysvita)

Attention: Nephrologists and Endocrinologists Effective Date: 1/6/2021 Call to action: Texas Children’s Health Plan (TCHP) is aligning prior authorization criteria for burosumab-twza (Crysvita), J0584, with the Texas Medicaid Provider Procedures Manual (TMPPM). Crysvita is a clinician administered drug indicated for members with X-linked hypophosphatemia (XLH) and Fibroblast Growth Factor 23 (FGF23)-related hypophosphatemia. Below are the new prior authorization criteria for TCHP members effective 01/06/2021. For initial therapy, the following criteria must be met: The client has a diagnosis of X-linked hypophosphatemia (XLH)...

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Provider Alert!
05Oct

Provider Alert! Concerta® to return to non-preferred status

Attention: All Providers Effective Date: October 16, 2020 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 Texas Vendor Drug Program (VDP) updated the Texas Medicaid formulary for STAR and STAR Kids members. The branded formulations of Concerta (methylphenidate ER) will be moved back to the non-preferred...

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Provider Alert!
29Sep

Provider Alert! Invoices Required for Manually Priced Laboratory Testing Claims Submissions

Attention: Laboratory Providers Effective Date: September 21, 2020 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: Laboratory providers submitting claims for COVID-19 testing or other services for a manually priced test must include the appropriate invoice(s) and documentation to ensure that manually priced laboratory claims...

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Provider Alert!
29Sep

Provider Alert! Limit increased for Code A4628, Oral Suction Catheter

Attention: All Providers Effective Date: September 22, 2020 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 effective September 22, 2020 the limit for HCPCS Code A4628, oral suction catheter has been increased from two...

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Provider Alert!
29Sep

Provider Alert! Prior Authorization Update for Botulinum Toxin Benefits with Diagnosis Restriction

  Date: May 20, 2021 Attention: All Providers   Effective Date: May 18, 2021 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 remind providers of the prior authorization requirements for Botulinum Toxin effective October 1, 2020. A prior authorization...

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Provider Alert!
29Sep

Provider Alert! Texas Medicaid and CHIP Immunization Alert – Vaccines for Specific Ages

Date: September 29, 2020 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 Center for Disease Control and Prevention (CDC) recommends the following vaccines for children and adolescents.  Please refer to this guide when scheduling your patients’ annual well visit.   Ages Vaccines 4 Through...

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Provider Alert!
24Sep

Provider Alert! Healthy Rewards/Value Added Services for 2020-2021

Attention: All Providers Effective Date: September 1, 2020 through August 31, 2021 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) is proud to present our Extra benefits/Value Added Services (VAS) program effective, September 1, 2020 through August 31, 2021....

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Provider Alert!
21Sep

Provider Alert! Update: Substance Use Disorder (SUD) Service Code H0050 now requires a Prior Authorization and Authorization Reminders

Attention: Behavioral Health Providers    Effective Date: September 23, 2020 for Code H0050 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) aligns with the prior authorization criteria available in the most recent Texas Medicaid Provider Procedures Manual (TMPPM), Withdrawal Management Services....

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15Sep

HEDIS Toolkit Offers Benefits to Providers

Members are cared for as HEDIS measures are met  Texas Children’s Health Plan developed a HEDIS Toolkit that contains helpful information regarding the measure requirements, standards and codes to use that are acceptable for HEDIS reporting. The new toolkit can be accessed here. This toolkit will serve as a reference form that can be used to code the type of appointments made and ensure that all of the HEDIS standards are met.  This will help providers maintain high quality care and meet...

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