Office Managers

Articles with relevant information for Office Managers.

Provider Alert!
03Oct

Provider Alert! EVV HHAeXchange: Transition and Updates for Alternative Devices

Date: October 2, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Effective Date: October 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that as part of the transition to the new, single and state-funded EVV system, the HHAeXchange Portal, Texas Human Services Commission (HHSC) has posted important dates, steps and information that impacts providers. Please see the details below or view the attachment from HHSC, EVV Transition: You Must Take Action Now! Effective...

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Provider Alert!
02Oct

Provider Alert! Upcoming Appointment Availability Secret Shoppers

Date: October 2, 2023 Attention: All Providers Effective Date: October 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers of the appointment availability standards. For your awareness, TCHP will conduct a secret shopper approach and call provider offices on their appointment availability starting this month. The surveys will occur on a quarterly basis going forward and TCHP will determine the providers to call at random. Appointment Availability Standards In 2015, Senate Bill 760 passed, requiring Texas Health and Human...

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Provider Alert!
29Sep

Provider Alert! Electronic Visit Verification (EVV) Data Conversion and Access to HHAeXchange

Date: September 28.2023 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers transitioning to HHAeXchange Call to action: Texas Children’s Health Plan (TCHP) would like to make providers aware that Texas Medicaid and Healthcare Partnership (TMHP) will transfer five years of profile data from the EVV systems, AuthentiCare or Vesta, to HHAeXchange. Program providers, FMSAs, and CDS employers who use these current EVV systems (AuthentiCare and Vesta), will lose access on December 22, 2023. All visit transactions in the EVV Aggregator will...

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Provider Alert!
29Sep

Provider Alert! UPDATE: 2023-24 RSV Season and Synagis Prior Authorization Begins October 2

Date: September 28, 2023 Attention: All Providers Call to action: Vendor Drug Program (VDP) announced the 2023-34 RSV season in a notice published to TexConnect on September 21, 2023. HHSC has since revised Form 1321 to address using the new product, Beyfortus, during the season. UPDATE: Health and Human Services (HHSC) revised the Synagis Standard Prior Authorization Addendum (HHS Form 1321) to reflect Beyfortus use. How this impacts providers: Here is a link to the 1321 form. Next step for Providers: Providers should utilize the...

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Provider Alert!
29Sep

Provider Alert! September 2023 Specialty Drug List Now Available

Date: September 28, 2023 Attention: All Providers Call to action: The September 2023 Biannual Specialty Drug List (SDL) is now available from the vendor drug program website. How this impacts providers: Providers should refer to the vendor drug program for more information about drugs covered on the SDL. Next step for Providers: Prescribers should share this update with their staff. If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.For access to all provider alerts,log into:www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.

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Provider Alert!
29Sep

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

Date: September 28, 2023 Attention: Providers of the programs referenced in this notice 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, reimbursement rate changes and updates for procedure codes presented at a public rate hearing on July 11, 2023, will be implemented. The adopted payment rates, effective September 1, 2023, can be accessed on the Provider Finance Department (PFD) webpage. The following...

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Provider Alert!
29Sep

Provider Alert! Collaborative Care Model (CoCM) in Texas Medicaid Billing Case Study Videos

Date: September 27, 2023 Attention: Providers of CoCM Services Date training videos are available: September 11, 2023 Background information: Texas Medicaid implemented a medical benefit for the CoCM on June 1, 2022, as directed by Senate Bill 672, 87th Legislature, Regular Session, 2021. Prior to the implementation of the benefit, HHSC conducted two trainings on CoCM services for MCOs in May of 2022. Call to action: To assist providers with billing and reimbursement of CoCM services, HHSC has developed a billing case study video...

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Provider Alert!
27Sep

Provider Alert! EVV Home Health Care Services (HHCS) Service Bill Codes Table Now Available

Date: September 26, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers, and FMSA Providers Call to action: Texas Children’s Health Plan (TCHP) would like to inform applicable providers that a new version of the electronic visit verification (EVV) Health and Human Services (HHCS) Bill Codes Table has posted. The table is on the EVV 21st Century Cures Act webpage in Excel and PDF formats. Background:Electronic Visit Verification (EVV) will be implemented for Medicaid home health care services (HHCS) on January 1, 2024. Program providers and financial management services agencies...

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Provider Alert!
27Sep

Provider Alert! 2023-24 RSV Season and Synagis Prior Authorization Begins Oct. 2 For Lower South Texas

Date: September 26, 2023 Attention: All Providers Effective date: October 2, 2023 Call to action: Health and Human Services Commission (HHSC) will begin the 2023-24 Medicaid and CHIP-covered monthly prophylaxis for RSV on October. 2, 2023, for all counties in State Health Service Region 11. We will not open any other regions for Medicaid coverage of RSV prophylaxis at this time. Refer to the season schedule for each region's start and end dates. HHSC will continue working with the Texas Pediatric Society's task force to determine...

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Provider Alert!
27Sep

Provider Alert! Clinical Criteria for Hemgenix® (procedure code J1411) effective November 1, 2023

Date: September 26, 2023 Attention: Physicians Effective date for prior authorization criteria: November 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective November 1 2023, the Texas Health and Human Services (HHSC) will be implementing prior authorization criteria for Hemgenix® (procedure code J1411) for fee-for-service Medicaid. Hemgenix (etranacogene dezaparvovec-drlb) is an adeno-associated virus vector-based gene therapy indicated to treat adult patients with Hemophilia B (congenital Factor IX deficiency). Prior Authorization Requirements: Coverage will be provided for...

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