Primary Care Providers

Articles with relevant information for Primary Care Providers (PCP).
10Aug

Improving Access to SBIRT

Improving Access to Screening, Brief Intervention, and Referral to Treatment in Primary Care for Adolescents: A Resource Center From the Center for Health Care Strategies, Inc. (CHCS) Adolescence is often a period for risky behavior and experimentation with alcohol and drugs. An estimated 70 percent of high school students have tried alcohol and 49 percent of high school seniors have used an illegal drug at least once. As a population, adolescents are more vulnerable than adults are to addiction. Early identification of...

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07Aug

Appointment Availability Standards for Primary Care and OB

Appointment availability standards What are appointment availability standards? How do you as a provider with Texas Children’s Health Plan play a role? In 2015 Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines. AFTER HOURS: Primary Care Physicians who are accessible 24 hours a day, seven days...

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11Jul

Texas Children’s Health Plan increases yearly gastrostomy button (G-button) limits

A message from Dr. Katy Ostermaier, Medical Director of STAR Kids at Texas Children’s Health Plan Texas Children’s Health Plan is pleased to announce an increase in gastronomy button (G-button) limits per year. As of February 26, 2019, we now allow 6 G-buttons to be dispensed per year. Families who have children with G-buttons can have a hard time getting the supply of replacement G-buttons needed when they break. An active child may need to replace broken G-buttons often, but Texas Medicaid...

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16Jun

For STAR Kids providers: Updated ANE Reporting Process

This requirement is effective September 1, 2018, and the updates have now been made in the UMCM – see Resources below.   As of September 1, 2018, all Texas Children’s Health Plan-contracted providers of Medically Dependent Children Program (MDCP) services are required to report all critical incidents, including Abuse, Neglect, and Exploitation (ANE), to the health plan. This action is to meet federal requirements regarding critical incident reporting (see links to federal requirements for incident reporting in below ‘Resources’ section).   MDCP providers contracted...

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01Jun

The new and improved Provider Portal is here!

The upgraded Texas Children’s Health Plan Provider Portal is now live! We have worked to bring a revamped user experience to our entire provider network. Our goal is to empower our providers with the tools to access accurate, timely data, so that they are able to deliver the best possible care to our members and their families. The redesigned portal features: Improved functionality for the claims, appeals, and messaging center Health Management Tools menu Access to Healthcare Effectiveness Data and Information Set (HEDIS®) data...

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21May

The YES Waiver for Medicaid Members: What You Need to Know

What is the YES Waiver? The Youth Empowerment Services (YES) Wavier is a Medicaid program that helps youth ages 3-18 years old with serious developmental, emotional, and behavioral difficulties. The YES waiver provides intensive services delivered within a strengths-based team planning process called wraparound. Wraparound builds on family and community support to build a family’s natural support network and connection with the community. The goal of the YES Waiver is to prevent out of home placement. It is a short-term waiver...

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10May

Perspectives on E-Cigarettes Webinar

If you take care of children in your practice, or have children of your own who are or will be teenagers, check out the American Thoracic Society’s latest webinar on e-cigarettes: “Perspectives on E-Cigarettes”. Presented by toxicologist Dr. Ilona Jaspers, PhD, this webinar will: Equip you with knowledge and strategies to deter teenagers from nicotine addiction and Provide helpful information on adolescents and e-cigarette use that you can incorporate into your practice Click here to view the webinar now!

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03May

May is Mental Health Awareness Month

May is Mental Health Awareness Month Year after year, more and more Americans face the reality of living with a mental illness. Despite their age, many young children show early signs of mental illness. These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors. “Half of all mental health disorders show first signs before a person turns 14 years old, and three quarters of mental health disorders begin before...

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02May

May 30 CME “Autism — Not Just a Checklist”

Save the date Texas Children’s Health Plan Grand Rounds CME Series Autism – Not Just a Checklist Target Audience: Texas Children’s Health Plan contracted behavioral health providers. Educational methods will include lectures with question and answer sessions. This activity is approved for a maximum of 2.0 AMA PRA Category I Credit(s). Thursday, May 30, 2019 5:30 p.m. Registration and Dinner 6 p.m. Scientific Session Activity Director: Lia Rodriguez, MD, FAAP Medical Director, Texas Children’s Health Plan Speakers: Bob Voigt, MD Chief of Services, Developmental Pediatrics Director, Autism Center, Texas Children’s Hospital Dinah...

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01May

The new and improved Provider Portal is here!

The upgraded Texas Children’s Health Plan Provider Portal is now live! We have worked to bring a revamped user experience to our entire provider network. Our goal is to empower our providers with the tools to access accurate, timely data, so that they are able to deliver the best possible care to our members and their families. The redesigned portal features: Improved functionality for the claims, appeals, and messaging center Health Management Tools menu Access to Healthcare Effectiveness Data and Information Set (HEDIS®) data...

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