Office Managers

Articles with relevant information for Office Managers.

Provider Alert!
19Oct

Provider Alert! Provider Reminder, Labor and Delivery Inpatient Information

Date: October 19, 2023 Attention: Obstetric Care Providers and Hospitals Effective date: Informational notice only Call to action: Texas Children’s Health Plan (TCHP) allows for up to three days prior to a delivery in addition to the federally mandated days after delivery.  Admissions resulting in delivery during this time frame do not require a prior authorization. Likewise, inpatient admissions for CHIP Perinate do not require authorization. How this impacts providers: Inpatient admissions related to spontaneous labor or induction of labor that result in delivery...

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19Oct

Provider Alert! Clinical Criteria for Qalsody® (procedure code C9157) effective October 1, 2023

Date: October 19, 2023 Attention: All Providers Effective Date: October 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective October 1, 2023, Texas Health and Human Services Commission (HHSC) will be implementing prior authorization criteria for Qalsody® (procedure code C9157).Qalsody® (Tofersen) is an antisense oligonucleotide indicated for the treatment of amyotrophic lateral sclerosis (ALS) in adults who have a mutation in the superoxide dismutase 1 (SOD1) gene Prior Authorization Requirements: Criteria for Initial Approval: Patient is 18...

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Provider Alert!
18Oct

Provider Alert! New Information – HHSC Adopts Proposed Payment Rates for Attendant Services in Various Programs

Date: October 18, 2023 Attention: Providers and Financial Management Services Agencies (FMSAs) Effective Date: September 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that effective for dates of service on or after September 1, 2023, Texas Health and Human Services Commission (HHSC) shared payment rate changes for attendant services. In response to the 2024-25 General Appropriations Act, House Bill 1, 88th Legislature, Regular Session, 2023 (Article II, HHSC, Rider 30(a)), HHSC has increased the base wage for...

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Provider Alert!
17Oct

Provider Alert! EVV Optional Services Now Available in PCS Bill Codes Table

Date: October 17, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Call to action: Texas Children's Health Plan (TCHP) would like to remind providers that the Texas Health and Human Service Commission (HHSC) has published a new version of the Electronic Visit Verification (EVV) Personal Care Services (PCS) Bill Codes Table. Version 12 is now available on the HHSC EVV webpage in Excel and PDF formats. The new version includes Supported Employment and Transportation as EVV optional services. Program providers and Financial Management Services Agencies (FMSAs) can...

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Provider Alert!
11Oct

Provider Alert! New Texas Medicaid & Healthcare Partnership (TMHP) Contracts

Date: October 10, 2023 Attention: All Providers Effective date: September 1, 2023 Call to action: The purpose of this communication is to inform providers that effective September 1, 2023 two new Texas Medicaid and Healthcare Partnership (TMHP) contracts went live: Accenture State Healthcare Services LLC (Accenture) is now the TMHP Business Operations and Business Integration (BusOps) vendor. The TMHP BusOps vendor acts as the project management office across the TMHP vendors and will manage the overall Medicaid ecosystem, including support services such as project management,...

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Provider Alert!
11Oct

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

Date: October 10, 2023 Attention: All Providers Event dates for the upcoming sessions are based on Service Delivery Area: Tuesday, December 5, 2023 Northeast SDAThursday, December 7, 2023 Jefferson SDATuesday, December 12, 2023 Harris SDAAll 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 in December and dates are based on Service Delivery Area (SDA) as described above. Click...

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Provider Alert!
09Oct

Provider Alert! Prior Authorization Requirements will be Changing in January 2024

Date: October 6, 2023 Attention: All Providers Effective date: January 2, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that there will be changes to the prior authorization requirements that become effective on January 2, 2024. Click here to view the requirements. Another resource, Prior Authorization Reference Information, is a searchable Prior Authorization list linked to the code tables for each benefit category and accessible here. How this impacts providers: The medical services listed on the Prior Authorization...

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Provider Alert!
05Oct

Provider Alert! CME Reminder: Opioid use disorder in Pregnancy- Screening, Intervention and Referral

Date: October 3, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that our current CME course, Opioid Use Disorder in Pregnancy – Screening, Intervention and Referral learning opportunity is still available and you have time to obtain credit for the 2023 year. Take advantage to learn screening brief intervention and referral (SBIRT) skills and review Eat Sleep Console (ESC) method to reduce the negative impact of Prenatal Opioid Use Disorders on women, children...

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Provider Alert!
05Oct

Provider Alert! Efficient Payment Option with Electronic Funds Transfer (EFT)

Date: October 5, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers of the electronic payment option available to expedite payment transactions. If you are not currently enrolled with electronic funds transfer (EFT), continue reading to learn more. We strongly encourage you to transition to EFT and experience the many benefits with this payment option. Benefits with EFT: Potential increased efficiency of payment processing between TCHP and providers due to support of auto-posting to billing/accounting system. Payments...

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Provider Alert!
03Oct

Provider Alert! UPDATED Medicaid Re-enrollment Application Assistance is Available

Date: October 3, 2023 Attention: All Providers Call to action: Texas Children's Health Plan (TCHP) would like to remind providers that assistance is available to their patients who need help with their Medicaid Reenrollment Application. Providers should encourage patients with Texas Children’s Health Plan coverage to contact us for assistance and support. In-person application assistance at provider officesIn-office Application Assistance may be available to providers that are interested in supporting the reenrollment process for their patients, pending availability and office location. To...

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