Specialists

Articles with relevant information for Specialists.

Provider Alert!
10Sep

Provider Alert! Ambulatory and Long-Term Electroencephalogram Benefits Changing for Texas Medicaid

Attention: All Providers        Effective Date: October 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 providers that effective for dates of service on or after October 1, 2020, ambulatory and long-term electroencephalogram (EEG) benefits...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
10Sep

Provider Alert! Irreparably Damaged DME Prosthetics, Orthotics, & Supplies during Hurricane Laura

Attention: DME Providers Date: September 9, 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) aligns with the guidance from Health & Human Services Commission (HHSC) regarding replacement of durable medical equipment (DME) supplies that may have been destroyed or lost...

By Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
02Sep

Provider Alert! 2020-21 RSV Season and Synagis (palivizumab)

Attention: All Providers Effective Date: September 24, 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: Respiratory Syncytial Virus (RSV) season is here! The Texas RSV region schedule and map can be found on the Texas Health and Human Services (HHSC) Vendor Drug Program (VDP) website. ...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
02Sep

Provider Alert! CMS Approves Multiple Allowances to Support Providers with Improving Performances and Incentive Payments Alike due to COVID-19 Pandemic

Attention: All Providers Effective Date: August 27, 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 you of the following notice from Health and Human Services Commission (HHSC). The COVID-19 pandemic has resulted in significant changes in care...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
25Aug

Provider Alert! Outpatient Medical Drug Billing Requirements Reminder

Attention: All Providers Effective Date: September 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: Effective September 1, 2020, TCHP will reject outpatient medical drug claims for clinician administered drugs (CADs) without the proper national drug code (NDC), healthcare common procedure coding system (HCPCS), and billing unit combination. The...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
20Aug

Provider Alert! Prior Authorization Guideline updates for Private Duty Nursing (PDN) and therapy specialty services

Attention: All Providers Effective Date: July 18, 2020 for PDN and August 11, 2020 for therapy Services 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...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
20Aug

Provider Alert! Uniform Opioid Policy Begins September 1

Attention: All Providers Effective Date: September 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: Effective September 1, 2020, the Vendor Drug Program (VDP) will implement a uniform opioid policy to encourage appropriate use and reduce opioid over-prescribing. The opioid policy does not apply to chronic pain, pain...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
19Aug

Reminder: Mandatory PMP verification to prescribe and dispense certain controlled substances

Attention: All Providers Effective Date: August 18, 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: This is a reminder that as of March 1, 2020, pharmacists and prescribers have been required to check the patient’s Prescription Monitoring Program (PMP) history before prescribing or dispensing...

By OB/GYNs, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
14Aug

Is It Anxiety or Does Kevin have COVID 19?

Clinical Vignette: It’s 4 p.m. on a busy Thursday. Kevin and his mother zoom into your office for the third time in six weeks. Today’s chief complaint is stomach pain and mild diarrhea. Kevin is 9 years old and has had some stomach issues in the past. His mother has been reading up on COVID-19 and heard that children more often present with stomach versus respiratory symptoms. The history does not really fit COVID-19 and you are starting to wonder about...

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Provider Alert!
12Aug

Provider Alert! Generic Albuterol Products Return to Non-Preferred Status for Medicaid Members

Attention: All Providers Effective Date: August 28, 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: Beginning August 28, 2020 the Texas Vendor Drug Program (VDP) will restore non-preferred status to a number of generic albuterol products. VDP temporarily removed nonpreferred status from these products...

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