Tag - Admissions

Provider Alert!

Provider Alert! New Prior Authorization Fax Line for Medical Inpatient Admissions and Discharge Notifications Authorization Reminders

Date: July 27, 2022 Attention: All Providers Effective date: August 1, 2022 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 a recent update to the prior authorization fax lines. New lines will be added for notification for...

Provider Alert! New Value Point of Origin for Admission of Visit Code “G,” In Use Beginning July 1, 2020 due to the COVID-19

Effective Date: July 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 July 1, 2020, a new value Point of Origin for Admission or Visit Code “G” has been established to...

No Prior Authorizations Required for Texas Children’s Health Plan (TCHP) In-Network Observations

1. In-network Observation stays do not require prior-authorization. 2. Hospital stays that include less than two bed days (less than “two midnights”) at the time of submission will be categorized as Observation Level of Care with some exceptions: a. Obstetrical deliveries b. Patient deaths c. Against Medical Advice (AMA) discharges d. Intensive Care Unit (ICU) admissions e. Pediatric Intensive Care Unit (PICU) admissions f. Pediatric Progressive Care Unit (PCU) g. Initial Neonatal Intensive Care Unit (NICU) admissions h. Neonatal Intensive Care Unit (NICU) readmissions within 28 days i. Behavioral Health...