Specialists

Articles with relevant information for Specialists.

29Jan

ADHD Provider Toolkit

What is it? Texas Children’s Health Plan is pleased to announce the unveiling of the ADHD Provider Toolkit. The ADHD Provider Toolkit is a go-to site for a wide range of relevant material to assist clinicians in the diagnosis, treatment, and management of patients with ADHD and their families. The goal is to provide information sources for the primary care provider who frequently sees patients with this diagnosis, thereby making evidence-based practices and tools available on the desktops of busy practitioners. How...

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21Jan

Training for Providers on Child Development Screening and Surveillance

The Child Developmental Screening and Surveillance web training is available on the Texas Health Steps Online Provider Education website: http://www.txhealthsteps.com/. The goal of this module is to equip Texas Health Steps providers and others with the skills to conduct developmental surveillance and screening during preventive medical checkups for children birth through 6 years; use approved screening tools; make appropriate referrals; and coordinate care in the primary care setting. Continuing education units are available for physicians, nurses, social workers, and Certified Health Education...

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19Jan

Save the Date February 8 CME

Save the Date Grand Rounds CME Series Hanging in the Balance: Ethics Perspective on Hospice Care & Provider Burn Out Provided by Texas Children’s Hospital and presented by Texas Children’s Health Plan   ACTIVITY DIRECTOR: Lia Rodriguez, MD, FAAP Medical Director, Texas Children’s Health Plan SPEAKERS: Tammy Kang, MD, MSCE Associate Professor of Pediatrics, Palliative Care, Baylor College of Medicine – Houston, TX Stacey R. Rose, MD, BA Associate Director, Assistant Professor, Internal Residency Program, Baylor College of Medicine – Houston, TX   Thursday, February 8, 2018 5:30 p.m. Registration & Dinner 6:00 p.m. - 8:00...

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07Jan

Newborn Hearing Screening Requirement

A newborn hearing screening must be completed at the birthing facility. Automated auditory brainstem response (AABR) or transient evoke or distortion product otoacoustic emissions (OAE) may be performed. If an infant is not born in a birthing facility and is not admitted to a birthing facility, the infant must be referred to a facility that provides newborn hearing screening. Newborns who do not pass the initial screen must be rescreened a second time in the birthing facility before discharge. Screening Results Birthing facilities must...

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17Dec

HEDIS Spotlight

HEDIS® (Healthcare Effectiveness Data and Information Set) is a widely used set of performance measures that ensures our members are getting the best health care possible. It is extremely important that our providers understand HEDIS® specifications and guidelines. This section highlights different HEDIS metrics in addition to providing descriptions of the measures, correct billing codes to support services rendered, and tips to direct you to corresponding resources and tools.   MEASURE: FOLLOW-UP AFTER HOSPITALIZATION FOR MENTAL ILLNESS MEASURE DESCRIPTION: Members 6 years of...

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17Dec

Smoking cessation available for parents and caregivers

Smoke-free homes lead to better health outcomes and reduced ED admissions for patients with asthma. Texas Children’s Health Plan provides free smoking cessation counseling and nicotine replacement products for the parents and caregivers of members with asthma. As a provider, you can help your patients more by supporting smoking cessation for parents and caregivers. If your practice site is interested in learning how to enroll parents/caregivers in this program, please contact Texas Children’s Health Plan’s Care Coordination team at 832-828-1008.

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11Dec

Provider Responsibilities

As a reminder, demographic changes must be sent in writing to Texas Children’s Health Plan within a minimum of 30 calendar days. Changes not received in writing are not valid. Texas Children’s Health Plan and its designated claims administrator are not responsible for potential claims processing and payment errors due to failure to update information. Notification of change should be made to Texas Children’s Health Plan Provider Relations and Care Coordination at the following email address: tchpprovrel@texaschildrens.org, or by fax...

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10Dec

Important Formulary Changes (Effective January 1, 2018)

Texas Children’s Health Plan formulary, preferred drug list, and prior authorization  forms can be found here: https://www.navitus.com/texas-medicaid-star-chip/formulary.aspx. Questions? Contact the Navitus Pharmacy Benefits Customer Care Team at 1-877-908-6023.

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05Dec

ADHD Provider Tool Kit

What is it? Texas Children’s Health Plan is pleased to announce the unveiling of the ADHD Provider Toolkit. This online resource went live in mid-November. The ADHD Provider Toolkit is a go-to site for a wide range of relevant material to assist clinicians in the diagnosis, treatment, and management of patients with ADHD and their families. The goal is to provide information sources for the primary care provider who frequently sees patients with this diagnosis, thereby making evidence-based practices and tools...

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21Oct

Appointment availability standards

What are appointment availability standards? How do you as a provider with Texas Children’s Health Plan play a role? In 2015 Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines. AFTER HOURS: Primary Care Physicians Accessible 24 hours a day, seven days a week, must return call...

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