Primary Care Providers

Articles with relevant information for Primary Care Providers (PCP).
14Aug

Is It Anxiety or Does Kevin have COVID 19?

Clinical Vignette: It’s 4 p.m. on a busy Thursday. Kevin and his mother zoom into your office for the third time in six weeks. Today’s chief complaint is stomach pain and mild diarrhea. Kevin is 9 years old and has had some stomach issues in the past. His mother has been reading up on COVID-19 and heard that children more often present with stomach versus respiratory symptoms. The history does not really fit COVID-19 and you are starting to wonder about...

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Provider Alert!
12Aug

Provider Alert! Generic Albuterol Products Return to Non-Preferred Status for Medicaid Members

Attention: All Providers Effective Date: August 28, 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: Beginning August 28, 2020 the Texas Vendor Drug Program (VDP) will restore non-preferred status to a number of generic albuterol products. VDP temporarily removed nonpreferred status from these products...

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Provider Alert!
06Aug

Provider Alert! Providers who are leaving the TCHP Participating Provider Network

Attention: All Providers Effective Date: State Fiscal QTR 3 & 4 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 and its continued governmental Emergency Declaration. CHANGES TO THE TCHP PARTICIPATING PROVIDER NETWORK The following is a list of providers and practitioners that have left and/or will be leaving...

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Provider Alert!
31Jul

Provider Alert! Child Psychiatry Access Network, free consultations for PCP’s caring for members with behavioral health concerns

Attention: Primary Care 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) collaborates with the Child Psychiatry Access Network (CPAN) who offers free consultations for Primary Care Providers (PCPs) who see children within the state of Texas.  CPAN is...

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Provider Alert!
31Jul

Provider Alert! Regulatory Guidelines & Appointment Availability Standards Reminder

Attention: Primary Care and Specialist 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) would like to remind network providers of the appointment availability standards and regulatory requirements.  In 2015, Senate Bill 760 passed, requiring Texas Health and Human Services Commission...

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Provider Alert!
31Jul

Provider Alert! EVV Update: Information Letter (IL) for Financial Management Services Agencies (FMSAs)

Attention: Financial Management Services Agencies (FMSAs) Effective Date: November 19, 2020 Call to action: Health and Human Services Commission (HHSC) has extended the Electronic Visit Verification (EVV) practice period through December 31, 2020. This allows Consumer Directed Services (CDS) employers to learn more about using the EVV system. During the practice period, EVV claims will not be denied for a mismatch. Beginning January 1, 2021, all service visits for an EVV-required service must be captured in the EVV system. Claims without a matching...

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31Jul

Provider Alert! THSteps Medical and Dental Checkups during COVID-19

Attention: Primary Care Providers Effective Date: October 22, 2020 The content in this message expired on October 23, 2020, as announced by the Health and Human Services Commission (HHSC). TCHP COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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...

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Provider Alert!
29Jul

Provider Alert! Vyondys-53 and Zolgensma updates

Attention: Neurologists Effective Date: July 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: Vyondys-53 is a clinician-administered drug benefit of Texas Medicaid with the effective date of April 1, 2020, under the Healthcare Common Procedure Code (HCPCS) miscellaneous code J3490/C9399 and an...

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Provider Alert!
28Jul

Provider Alert! Metabolic Monitoring for Children and Adolescents on Antipsychotics Reminder

Date: October 4, 2021 Attention: Primary Care and Behavioral Health 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) is actively working on a Performance Improvement Project (PIP) for members, ages 1-17, who are taking antipsychotic medications. This PIP is part...

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Provider Alert!
28Jul

Provider Alert! Hypertension intervention campaign, Release the Pressure

Attention: All Providers Effective Date: July 20, 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 invite you to participate in a new campaign, launched by several healthcare organizations, focused on helping black women learn more about...

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