Provider Alert

Articles with information about Provider Alerts.

Provider Alert!
22Apr

Provider Alert! Provider Portal Provides Instant Access to Claims and Member Information

Date: April 22, 2022  Attention: All Providers Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal claims unless denied...

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Provider Alert!
21Apr

Provider Alert! MCO Compliance with H.B. 2822 provisions related to PA for Antipsychotic Drugs Required by May 20

Date: April 21, 2022 Attention: Behavioral Health Providers Effective Date: May 20, 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: Managed care contracts require MCOs to comply with Texas Government Code § 531.073 under the section titled “Compliance with State and Federal Prior Authorization Requirements”...

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Provider Alert!
20Apr

Provider Alert! STAR Kids Long-Term Services and Supports Billing Matrix Revisions

Date: April 14, 2022 Attention: All Providers Effective date: September 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required...

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Provider Alert!
12Apr

Provider Alert! March 2022 Specialty Drug List Available

Date: April 7, 2022 Attention: Providers Effective Date: March 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: The March 2022 Biannual Specialty Drug List is now available from the Vendor Drug Program Website. How this impacts providers: A drug must meet all four of the...

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Provider Alert!
12Apr

Provider Alert! Texas Health Steps Quick Reference Guide Updated for March 2022

Date: April 7, 2022 Attention: Primary Care Providers Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal claims...

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Provider Alert!
12Apr

Provider Alert! Benefit Criteria for Evoked Response Tests and Neuromuscular Procedures Update

Date: April 7, 2022 Attention: Neurologists Effective date: March 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to...

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Provider Alert!
12Apr

Provider Alert! Update to Prostate Procedures for Benign Prostatic Hyperplasia Benefit Criteria

Date: April 7, 2022 Attention: Urologists Effective date: October 1, 2021 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to...

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Provider Alert!
11Apr

Provider Alert! Laser Interstitial Thermal Therapy to Require Prior Authorization

Date: April 6, 2022   Attention: Radiologists Effective date: July 5, 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. Regarding system configuration updates, TCHP will apply updates and reprocess impacted claims as soon as possible. However, due to volume, please allow up to sixty (60) business days...

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Provider Alert!
06Apr

Provider Alert! Age Range Updates for Drug Procedure Codes Effective April 1

Date: April 6, 2022 Attention: Providers Effective Date: April 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: On April 1, 2022, HHSC updated age ranges for drug procedure codes Q0167, Q0169, and Q0175 for Medicaid and CHIP. How this impacts providers: Dronabinol (procedure code Q0167)...

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Provider Alert!
06Apr

Provider Alert! Age and Diagnosis Restriction Updates for Drug Procedure Codes, Effective March 1

Date: April 6, 2022 Attention: Providers Effective Date: March 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: On March 1, 2022, HHSC updated age and diagnosis restrictions for drug procedure codes J0596, J0598, J0599, and J9348 for Medicaid and CHIP. Fee-for-service criteria for J0596,...

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