Primary Care Providers

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

Provider Alert!
13Sep

Provider Alert! EVV HHAeXchange Updates: Take Action Now and Onboard, EVV Systems AuthentiCare and Vesta and EVV Alternative Device PolicyProvider Alert!

Date: September 12, 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 Texas Health and Human Services Commission (HHSC) has selected HHAeXchange as the state EVV vendor. Take Action Now: Onboard with HHAeXchange To remain compliant with EVV requirements, program providers and FMSAs transitioning to HHAeXchange or who have recently enrolled to provide personal care services (PCS), must complete onboarding and system user training before Oct. 1. Submit the HHAeXchange Provider...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
08Sep

Provider Alert! Updated Clinical Prior Authorizations Criteria Guides

Date: September 8, 2023 Attention: All Providers Effective Date: July 31, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that the Texas Health and Human Services (HHSC) updated multiple clinical prior authorization criteria guides effective July 31, 2023. How this impacts providers: HHSC updated the following clinical prior authorization criteria guides with the noted changes: Anxiolytics/Sedatives/Hypnotics (ASH) Ramelteon Corrected step 4 in the Ramelteon criteria logic and diagram. Diazepam Added GCNs for diazepam (45092, 14210) to the prior authorization table Cytokine...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
01Sep

Provider Alert! Annual Chlamydia Screening Reminder

Date: September 1, 2023 Attention: OBGYNs and Primary Care Providers Annual chlamydia screening is recommended for all sexually active women ages 16 to 24, as well as older women with risk factors such as new or multiple sex partners, or a sex partner who has a sexually transmitted infection. Nucleic Acid Amplification Tests (NAATs) are the most sensitive tests, and can be performed on easily obtainable specimens, such as urine or vaginal swabs clinician- or patient-collected). Why it matters: Chlamydia is the most commonly...

By OB/GYNs, Primary Care Providers, Provider Alert, , 0 CommentsRead more...
Provider Alert!
01Sep

Provider Alert! EVV HHAeXchange Updates: Onboarding, System User Training & Alternative Device Policy

Date: September 1, 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 Texas Health and Human Services Commission (HHSC) has selected HHAeXchange as the state EVV vendor. Onboarding The HHAeXchange Provider Onboarding Form is used to create and configure the HHAeXchange Portal. The person who submits the form will be the provider’s point of contact and will receive all communication from HHAeXchange. Personal care services program providers and Financial...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
Provider Alert!
31Aug

Provider Alert! Hepatitis C Resources for Your Patients

Date: August 25, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to make providers aware of new resources on Hepatitis C available from the Health and Human Services Commission (HHSC) available to your Medicaid patients with the named diagnosis. The resources were created to increase the awareness for treating Hepatitis C. How this impacts providers: The new resources are available below for your Medicaid patients. Hep C Notice English                       Hep C Notice Spanish   Resources: ●      txvendordrug.com/formulary/hepatitis-c ●      hhs.texas.gov/services/health/prevention/hepatitis-c-treatment Previously published communication...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
30Aug

Provider Alert! Radiology Benefit Updates for Texas Medicaid Effective September 1, 2023

Date: August 30, 2023 Attention: All Providers Effective Date: September 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that certain radiology benefit updates will be effective for Texas Medicaid for dates of service on or after September 1, 2023. Major changes include the following: The addition of benefit information for magnetic resonance elastography (MRE) New benefit for ultrasound transient elastography (TE) MRE (procedure code 76391) may be reimbursed for the diagnosis or monitoring of liver fibrosis or cirrhosis in...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
29Aug

Provider Alert! Medicaid Re-enrollment: Patients May Risk Losing Their Medicaid Plan!

Date: August 28, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to thank you for supporting your patients with maintaining coverage during the Medicaid re-enrollment currently underway. Background information: As you may know, Medicaid coverage rules have changed, and some Medicaid recipients need to go through the renewal process to determine their eligibility for coverage. This is the result of the Consolidated Appropriations Act, 2023 (CAA, 2023) that was enacted on December 29, 2022. The CAA ended the...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
29Aug

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

Date: August 29, 2023 Attention: All Providers Thursday, September 21, 2023 Northeast SDATuesday, September 26, 2023 Jefferson SDAThursday, September 28, 2023 Harris SDANEW TIME: All 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 next month and dates are based on Service Delivery Area (SDA) as described above. Click here if you are not sure of your SDA....

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
28Aug

Provider Alert! HHSC to Add Skysona® as Medicaid and CHIP Benefit July 1, 2023, Prior Authorization Effective September 1, 2023

Date: August 24, 2023 Attention: All Providers Effective Date: September 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to let providers know that effective September 1, 2023, the Texas Health and Human Services (HHSC) will be implementing required prior authorization criteria for Skysona® (procedure code J3590) for Medicaid and CHIP. Skysona® will become a benefit of Medicaid and CHIP on July 1, 2023. Skysona® (betibeglogene autotemcel) is indicated to slow the progression of neurologic dysfunction in boys 4-17 years...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , , 0 CommentsRead more...
Provider Alert!
23Aug

Provider Alert! CHIP $20,000 CAP for Durable Medical Equipment (DME), Prosthetic Devices and Disposable Medical Supplies Now Active

Date: August 22, 2023 Attention: CHIP Providers Effective date: May 23, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that in accordance with the Uniform Managed Care Manual, for CHIP Members, there is a $20,000 12-month period limit for DME, prosthetics, devices and disposable medical supplies limitation (diabetic supplies and equipment are not counted against this cap). Covered services require prior authorization and physician prescription when in excess of benefit limitations for members 20 years of age...

By OB/GYNs, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...