Provider Alert

Articles with information about Provider Alerts.

Provider Alert!

Provider Alert! Fetal Magnetic Resonance Imaging (MRI) Requires Prior Authorization

Date: October 11, 2021 Attention: All Providers Effective Dates: June 1, 2021 for code 74712 and April 1, 2021 for code 74713 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: Network providers submitting a prior authorization for fetal Magnetic Resonance Imaging (MRI) should include a [...]

Provider Alert!

Provider Alert! 90-Day Notice of EVV Compliance for Cures Act Personal Care Services Providers

Date: October 1, 2021 Attention: Financial Management Services Agencies and Consumer Directed Services employers Effective Date: January 1, 2022 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 January 1, 2022, the payers, Health and Human Servcies commission (HHSC) and TCHP, will begin Electronic Visit [...]

Provider Alert!

Provider Alert! Misuse of EVV Reason Codes Requirements Removed

Date: October 1, 2021 Attention: Financial Management Services Agencies and Consumer Directed Services employers Effective Date: September 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: The Health and Human Services Commission (HHSC) removed the Misuse of EVV Reason Codes Requirements from the EVV [...]

Provider Alert!

Provider Alerts – EVV Usage Compliance Review Grace Period Extended

Date: October 1, 2021 Attention: Consumer Directed Services Employers New Compliance Review Due Date: August 31, 2022 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 requires Electronic Visit Verification for all Medicaid personal care services, including services managed through the Consumer Directed Services (CDS) [...]

Provider Alert!

Provider Alert! Rural Hospitals Outpatient Ratio of Cost to Charges update

Date: September 20, 2021 Attention: Rural Hospitals Effective Date: September 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: The Health and Human Services Commission (HHSC) increased the Rural Hospitals Outpatient Ratio of Cost to Charges (RCC) effective for dates of service September 1, [...]

Provider Alert!

Provider Alert! Chantix (Varenicline) Tablets Voluntary Recall

Date: September 22, 2021 Attention: All Providers and Pharmacies Effective Date: September 16, 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: Pfizer has issued a voluntary recall of all lots of CHANTIX (Varenicline) Tablets. Potentially impacted customers were notified with a recommendation to not [...]

Provider Alert!

Provider Alert! 2021-2022 Respiratory Syncytial Virus Season and Synagis (palivizumab)

Date: July 23, 2021 Attention: All Providers Treatment start date: October 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. **This notice may be updated as new regions are opened or closed Call to action: The traditional 2021-22 Respiratory Syncytial Virus (RSV) season is here! The Texas RSV [...]

Provider Alert!

Provider Alert! Provider Claims Appeal Report now offers a Status Update on the Provider Portal

Date: September 20, 2021 Attention: All Providers Effective Date: September 9, 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: A new enhancement for the provider portal claims appeal report includes a status update for appeals submitted September 9, 2021 or later. How this impacts providers: [...]

Provider Alert!

Provider Alert! Postpartum Care Visit Update for CHIP Perinate

Date: September 13, 2021 Attention: Obstetric Care Providers Effective Date: December 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 will align with Texas Medicaid Providers Procedure Manual (TMPPM) for CPT Code 59430. Effective December 1, 2021 postpartum visit code [...]

Provider Alert! COVID-19 Monoclonal Antibody Therapy Procedure Code Update

Date: September 20, 2021 Attention: All Providers Subject: COVID-19 Monoclonal Antibody Therapy Procedure Code Update Effective Date for procedure code M0243 is July 30, 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 would like to inform network providers that Texas Medicaid [...]