Specialists

Articles with relevant information for Specialists.

Provider Alert!
12Feb

Provider Alert! Subject: Prior Authorization Guideline updates for Private Duty Nursing (PDN)

Attention: All Providers Effective Date: March 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: TCHP would like to inform you of recent updates to the prior authorization requirements and the effective dates. Updates include the following: Private Duty Nursing, effective March 1, 2021: Nursing notes,...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
12Feb

Provider Alert! Attention: Behavioral Health Providers and inpatient facilities

Attention: Behavioral Health Providers and inpatient facilities 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 (TCHP) would like to remind network providers that we require all members receiving inpatient psychiatric services to be scheduled prior to discharge for outpatient follow-up...

By Facilities, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
02Feb

Provider Alert! Colorectal Cancer Screening Benefit Criteria to Change for Texas Medicaid

Attention: PCPs and Oncologists Effective Date: March 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: Effective for dates of service on or after March 1, 2021, colorectal cancer screening benefit criteria will change for Texas Medicaid. Fecal occult blood tests, multi-targeted stool deoxyribonucleic...

By Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
Provider Alert!
01Feb

Provider Alert! New Edit Implemented by Claims Processor, Change HealthCare

Attention: All Providers       Effective Date: February 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 (TCHP) would like to inform network providers that beginning February 1, 2021, Change Health Care (CHC) will require the following information on all UB04 (837I)...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
01Feb

Provider Alert! Medical Physics Consultations to Become Benefits of Texas Medicaid

Attention: Oncologists Effective Date: March 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: Effective for dates of service on or after March 1, 2021, medical physics consultations (procedure codes 77336 and 77370) will become benefits of Texas Medicaid. Medical physics consultations will be...

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Provider Alert!
29Jan

Provider Alert! Provider Initiated Termination Process and Requirements

Date: August 13, 2021 Attention: All Providers Effective Date: December 1, 2020 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 (TCHP) would like to inform network providers of the provider initiated termination process and requirements. A provider may terminate from Texas Children’s...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
29Jan

Provider Alert! Medicaid drug formulary changes

Date: January 26, 2021 Attention: All Providers Effective Date: January 28, 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 Texas Vendor Drug Program (VDP) will implement changes to the state Medicaid drug formulary, effective Thursday, January 28, 2021. Select medications will be moving from...

By OB/GYNs, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
28Jan

Provider Alert! Oseni and the Thiazolidinediones (TZD) Clinical Prior Authorization Update

Date: January 26, 2021 Attention: Primary Care Providers and Endocrinologists  Effective Date: February 4, 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 (TCHP) would like to inform network providers that beginning February 4, 2021 Texas Medicaid will remove the Thiazolidinediones (TZD)...

By Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
28Jan

Provider Alert! Dupixent Clinical Prior Authorization Criteria Revision

Date: January 26, 2021 Attention: PCPs, Allergists, Pulmonologists, and Dermatologists Effective Date: March 15, 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: Effective March 15, 2021, Texas Medicaid will revise criteria of the Dupixent (dupilumab) clinical prior authorization. This is only applicable to medications dispensed...

By Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
28Jan

Provider Alert! Injectable and Oral Desmopressin Clinical Prior Authorization Update

Date: January 26, 2021 Attention: PCPs, Endocrinologists, and Hematologists Effective Date: March 15, 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: Effective March 15, 2021, Texas Medicaid will revise the injectable and oral desmopressin clinical prior authorizations to remove the denial criterion for hyponatremia. This...

By OB/GYNs, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...