Primary Care Providers

Articles with relevant information for Primary Care Providers (PCP).

Provider Alert!

Provider Alert! 2021 Texas Brain Injury Conference and Virtual Webinar Series

Date: February 19, 2021 Attention: 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) extends an invite to network providers for the 2021 Texas Brain Injury Conference and Webinar Series sponsored by the Texas Brain Injury Programs at [...]

Provider Alert!

Provider Alert! Macrolides Clinical Prior Authorization Update

Date: February 19, 2021 Attention: Primary Care Providers Effective Date: March 15, 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 inform network providers that beginning March 15, 2021 Texas Medicaid will change the preferred drug list [...]

Provider Alert!

Provider Alert! Zika Prevention:  Mosquito Repellant Benefit Update

Date: February 10, 2021 Attention: Primary Care Providers Effective Date: February 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 inform network providers that effective February 18, 2021 Texas Medicaid will renew a standing order for [...]

Provider Alert! Talking with Patient’s about the COVID -19 Vaccination

Date: February 19, 2021 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: Texas Children’s Health Plan (TCHP) strongly encourages network providers to engage in conversation with our members on the importance of receiving the COVID-19 vaccination. Here are some suggestions from [...]

Provider Alert!

Provider Alert! CPT Coding for Self-Measured Blood Pressure Monitoring

Date: February 18, 2021 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: Texas Children’s Health Plan would like to inform network providers of Current Procedural Terminology (CPT®) Codes available to support self-measured blood pressure monitoring. How this impacts providers: The CPT Codes [...]

Provider Alert!

Provider Alert! Transport to and from Shelters

Date: February 17, 2021 Attention: Ambulance Transport Companies Effective Date: February 15, 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: In response to the current weather conditions, effective February 15 through February 19, 2021, Texas Children’s Health Plan will reimburse for ambulance transportation of [...]

Texas Children’s Health Plan to host special live CME event

Eating Disorders and Gynecologic Care for Young Women  Recognize eating disorders and common menstrual problems, and know the resources available for at-risk patients to sex trafficking. This is a free, online CME course for contracted providers of the health plan provided by Texas Children’s Hospital. Thursday, February 25, 2021 – 5:30 p.m. - 7:30 p.m. – Live stream via WebEx Topics covered will include: Eating disorders Amenorrhea Abnormal Uterine Bleeding STIs Contraception Sex Trafficking To register today, click here. For questions, email [...]

Provider Alert!

Provider Alert! Subject: Prior Authorization Guideline updates for Private Duty Nursing (PDN)

Attention: All Providers Effective Date: March 1, 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: TCHP would like to inform you of recent updates to the prior authorization requirements and the effective dates. Updates include the following: Private Duty Nursing, effective March 1, 2021: Nursing [...]

Provider Alert!

Provider Alert! Colorectal Cancer Screening Benefit Criteria to Change for Texas Medicaid

Attention: PCPs and Oncologists Effective Date: March 1, 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: Effective for dates of service on or after March 1, 2021, colorectal cancer screening benefit criteria will change for Texas Medicaid. Fecal occult blood tests, multi-targeted stool [...]

Provider Alert!

Provider Alert! New Edit Implemented by Claims Processor, Change HealthCare

Attention: All Providers       Effective Date: February 1, 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 inform network providers that beginning February 1, 2021, Change Health Care (CHC) will require the following information on all UB04 [...]