Primary Care Providers

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

Provider Alert!
18Feb

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 include...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , , , 0 CommentsRead more...
Provider Alert!
17Feb

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 technology...

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12Feb

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 tchpcme@texaschildrens.org The...

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Provider Alert!
12Feb

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 notes,...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
02Feb

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 deoxyribonucleic...

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Provider Alert!
01Feb

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 (837I)...

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Provider Alert!
29Jan

Provider Alert! Provider Initiated Termination Process and Requirements

Date: August 13, 2021 Attention: All Providers Effective Date: December 1, 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 network providers of the provider initiated termination process and requirements. A provider may terminate from Texas Children’s...

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Provider Alert!
29Jan

Provider Alert! Medicaid drug formulary changes

Date: January 26, 2021 Attention: All Providers Effective Date: January 28, 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: The Texas Vendor Drug Program (VDP) will implement changes to the state Medicaid drug formulary, effective Thursday, January 28, 2021. Select medications will be moving from...

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Provider Alert!
28Jan

Provider Alert! Oseni and the Thiazolidinediones (TZD) Clinical Prior Authorization Update

Date: January 26, 2021 Attention: Primary Care Providers and Endocrinologists  Effective Date: February 4, 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 4, 2021 Texas Medicaid will remove the Thiazolidinediones (TZD)...

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Provider Alert!
28Jan

Provider Alert! Dupixent Clinical Prior Authorization Criteria Revision

Date: January 26, 2021 Attention: PCPs, Allergists, Pulmonologists, and Dermatologists 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: Effective March 15, 2021, Texas Medicaid will revise criteria of the Dupixent (dupilumab) clinical prior authorization. This is only applicable to medications dispensed...

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