Provider Alert – Page 87

Articles with information about Provider Alerts.

05MayMay 5, 2016

Provider Alert! Reminder on the use of the U8 Modifier

To: All Texas Children’s Health Plan Providers Subject: Reminder on the use of the U8 Modifier All eligible organizations and covered entities that are enrolled in the Federal 340B Drug Pricing Program to purchase 340B discounted drugs must use modifier U8 when submitting claims for 340B clinician-administered drugs. Non-compliance with this new requirement to use modifier U8 on all claims submitted for 340B clinician-administered drugs may jeopardize a covered entity’s 340B status with the U.S. Department of Health and Human Services Health Resources...

By Texas Children's Health PlanOffice Managers, Provider AlertDrug Pricing, HRSA, provider alert, U8 Modifier0 CommentsRead more...

21JanJanuary 21, 2016

Provider Alert! Authorization requirement for non-emergent ambulance transfer

To: All providers Subject: Authorization requirement for non-emergent ambulance transfer Effective: April 1, 2016 Texas Children’s Health Plan members who require the use of an ambulance for non-emergent transport must have the request for authorization submitted by the member’s physician, facility or health-care provider. The request will be reviewed to determine if alternate means of transportation can be utilized for transport to a scheduled medical appointment or to and from a treating facility. Texas Children’s Health Plan does not accept authorization requests from ambulance/medical...

By Texas Children's Health PlanFacilities, Provider Alertambulance, emergency, facilities, transportation0 CommentsRead more...

21JanJanuary 21, 2016

Provider Alert! Annual Reminder on Copayments and Deductibles

To: All Texas Children’s Health Plan Providers Subject: Annual Reminder on Copayments and Deductibles Texas Children’s Health Plan will pay for a primary insurance deductible with proof of assignment to the deductible on the primary evidence of procedure. Payments will be made up to Medicaid allowable only. Claims for primary insurance copayments should be sent to Texas Medicaid and Healthcare Partnership directly. Texas Children’s Health Plan will not pay CP001 or CP002 on a claim as these are not payable by the managed...

By Texas Children's Health PlanOffice Managers, Provider Alertcopayments, deductibles, insurance, medicaid, provider alert0 CommentsRead more...

23DecDecember 23, 2015

Provider Alert! Billing Update for Texas Health Steps

To: All Texas Health Steps Providers Subject: Reminder – Billing for Texas Health Steps Services to Texas Children’s Health Plan Texas Children’s Health Plan follows the State of Texas Medicaid guidelines for Texas Health Steps checkups including the following: “Texas Health Steps medical checkups reflect the federal and state requirements for a preventive checkup. Preventive care medical checkups are a benefit of the Texas Health Steps program if they are provided by enrolled Texas Health Steps providers and all of the required components...

By Texas Children's Health PlanOffice Managers, Primary Care Providers, Provider Alertcheckups, periodicity, preventive care, provider alerts, providers, texas health steps, th steps0 CommentsRead more...

23DecDecember 23, 2015

Provider Alert! Long Acting Reversible Contraception (LARC) Billing Changes

To: All Providers and Facilities Subject: Long Acting Reversible Contraception (LARC) Billing Changes Recent changes at Health and Human Services Commission (HHSC) has improved the accessibility of LARC devices for Medicaid members. HHSC is currently working to add ParaGard, Nexplanon and Liletta to the Medicaid Vendor Drug Program formulary. More information on these products and the process to order will be supplied as these are added. Once added, providers may choose to continue to “buy and bill” or they may choose to...

By Texas Children's Health PlanOB/GYNs, Office Managers, Provider Alertbilling, contraception, hhsc, insurance, LARC, medicaid, provider alert, provider relations, reversible contraception0 CommentsRead more...

01SepSeptember 1, 2015

Provider Alert! Preventing Pre-Term Pregnancies

To: All Providers Subject: Effective September 1, 2015 all Progesterone therapy will require a pre-authorization from Texas Children’s Health Plan. Claims billed using the branded Makena will no longer require a U1 modifier. Pre-authorized use of Makena (hydroxyprogesterone caproate injection) will need to be submitted as J1725 with the appropriate NDC information as required on all claims. Claims billed using the compounded 17-P therapy will now require the U1 modifier. Pre-authorized use of 17-P will need to be submitted as J1725 with the...

By Texas Children's Health PlanOB/GYNs, Provider Alertclaims, pre-authorization, pre-term, pregnancy, pregnant, progesterone, provider alert, providers0 CommentsRead more...