Provider Alert

Articles with information about Provider Alerts.

Provider Alert!

Provider Alert! Prior Authorization Signature Requirements

Date: November 20, 2023 Attention: All Providers Effective Date: December 20, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that per Texas Medicaid Provider Procedures Manual (TMPPM) Section 5.1, only wet or electronic signatures are accepted for prior authorizations. Prescribing or ordering providers, dispensing providers, clients’ responsible adults, and clients may sign prior authorization forms and supporting documentation using electronic or wet signatures. Stamped signatures, typed fonts, and images of wet signatures are not accepted. How this impacts...

Provider Alert!

Provider Alert! EVV Cures Act Home Health Care Services (HHCS): Onboard Now

Date: November 17, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Effective Date: January 1, 2024 Call to action: Texas Children’s Health Plan (TCHP) would like to remind program providers and financial management services agencies (FMSAs) who will be new to EVV, due to the Cures Act Home Health Care Services implementation, must complete onboarding and EVV Portal training by December 31. It's recommended to complete the form as soon as possible to be able to practice using EVV before the January...

Provider Alert!

Provider Alert! Timeframe for follow-up from an Inpatient Behavioral Health Facility

Date: November 17, 2023 Attention: Behavioral Health Providers and inpatient facilities Call to action: Texas Children’s Health Plan (TCHP) request that all members receiving inpatient psychiatric services be scheduled prior to discharge for outpatient or lower level of care follow-up with an in network behavioral health provider. To search for TCHP network behavioral health providers, click here. The timeframe requirements are as follows: Initial outpatient treatment after discharge must occur within seven (7) days from the date of discharge. The appointment should not occur...

Provider Alert!

Provider Alert! Texas Children’s Health Plan Celebrated Cultural Awareness Week

Date: November 15, 2023 Attention: All Providers Call to action: We are excited to announce that Texas Children’s Health Plan (TCHP) celebrated Cultural Awareness week, November 6-10, 2023! TCHP fosters an environment of diversity, equity and inclusion by providing the right resources for our network of providers to better serve our culturally diverse member population. During Cultural Awareness week we provided trainings and panels for our staff to better help them serve our diverse member population.   We invite you to learn more about...

Provider Alert!

Provider Alert! EVV Claims Matching Resumes January 1

Date: November 15, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Call to action: Texas Children’s Health Plan (TCHP) would like to remind program providers, financial management services agencies (FMSAs) and Consumer Directed Services (CDS) employers that Electronic Visit Verification (EVV) claims matching for all services required to use EVV will begin on January 1, 2024. EVV claims with dates of service on or after January 1 that do not have an EVV visit match, will be denied. Email TMHP to...

Provider Alert!

Provider Alert! Texas Children’s® Link: Setting up Challenge Questions

Date: November 7, 2023 Attention: All Texas Children's® Link Portal Users Call to action: Texas Children’s Hospital and Texas Children’s Health Plan have a responsibility to safeguard the privacy of all Texas Children’s Hospital patients and Texas Children’s Health Plan members and to protect the confidentiality of their health information. In order to help protect privacy and provide an easier way to reset passwords, we would like to invite all end users who use the Texas Children's® Link portal to set up...

Provider Alert!

Provider Alert! COVID-19 Vaccine and Vaccine Administration Procedure Codes 91318, 91319, 91320, 91321, 91322, and 90480 Are Now Benefits of Medicaid and CHIP

Date: November 7, 2023 Attention: All Providers Effective for dates of service on or after September 11, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that in accordance with the U.S. Food and Drug Administration’s amended Emergency Use Authorizations COVID-19 vaccine administration codes for the Pfizer-BioNTech and Moderna COVID-19 vaccines, vaccine procedure codes 91318, 91319, 91320, 91321, 91322, and vaccine administration procedure code 90480 are benefits for Medicaid and CHIP. How this impacts providers: The procedure codes are...

Provider Alert!

Provider Alert! Telemedicine and Telehealth Benefit Updates for Rural Health Clinics and Federally Qualified Health Centers Effective November 1, 2023

Date: November 7, 2023 Attention: Rural Health Clinics and Federally Qualified Health Centers Effective date: November 1, 2023 Call to action: The purpose of this communication is to provide guidance on the implementation of a new telehealth patient site facility fee benefit for federally qualified health center (FQHC) and rural health clinic (RHC) providers. How this impacts providers: Effective for dates of service on or after November 1, 2023, FQHC and RHC providers performing patient-site telehealth services may be reimbursed for the facility fee...

Provider Alert!

Provider Alert! Texas Children’s® Link: Efficiently Submit Prior Authorizations

Date: November 6, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that they can submit prior authorizations securely online via Texas Children's® Link, our online provider portal. Providers are encouraged to submit authorization requests on our portal since this is the most efficient way for our team to process authorizations. To access Texas Children's® Link, click here. Important benefits of using the new portal to submit authorizations include: Real time access to authorization status information –...

Provider Alert!

Provider Alert! Vaccine Services Benefits Changes for Texas Medicaid

Date: November 6, 2023 Attention: All Providers Effective: October 1, 2023 Call to Action: Texas Children Health Plan (TCHP) would like to let providers know that effective for dates of service on or after October 1, 2023, vaccine services benefits have changed for Texas Medicaid.  On June 27, 2023, the Centers for Medicare & Medicaid Services (CMS) issued guidance on Section 11405 of the Inflation Reduction Act (IRA). Beginning October 1, 2023, statutory amendments made by Section 11405 of the IRA require Medicaid coverage...