Tag - Authorization

Provider Alert!

Provider Alert! Appointment Availability Standards Reminder

Date: November 3, 2022   Attention: Primary Care and Specialist Providers 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 providers of the appointment availability standards. In 2015, Senate Bill 760 passed, requiring Texas Health and Human [...]

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 [...]

Provider Alert!

Provider Alert! Guidance on Medicaid Coverage of Generators

Date: March 29, 2022 Attention: All Providers Effective date: June 27, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not [...]

Provider Alert!

Provider Alert! Online Authorization Platform is Able to Accept Additional Clinical Information 

Date: April 8, 2021 Attention: All Providers 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 utilize our online authorization platform; Health Trio that this platform is now accepting additional clinical information once [...]

Provider Alert!

Provider Alert! Macrolides Clinical Prior Authorization Update

Date: February 19, 2021 Attention: Primary Care Providers 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: Texas Children’s Health Plan (TCHP) would like to inform network providers that beginning March 15, 2021 Texas Medicaid will change the preferred drug list [...]

Provider Alert!

Provider Alert! Transport to and from Shelters

Date: February 17, 2021 Attention: Ambulance Transport Companies Effective Date: February 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: In response to the current weather conditions, effective February 15 through February 19, 2021, Texas Children’s Health Plan will reimburse for ambulance transportation of [...]

Provider Alert!

Provider Alert! Online Authorization Platform is Now Operational

Date: January 13, 2021 Attention: All Providers   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 utilize our online authorization platform; Health Trio this platform is restored and is now functional and accepting authroizations. How [...]

Provider Alert!

Provider Alert! Essential Information for Prior Authorization Submission

Date: January 13, 2021 Attention: All Providers 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 of the required information for a prior authorization submission. The Texas Standard Prior Authorization Form* including the following information: Member [...]

Provider Alert!

Provider Alert! TCHP Fax Lines Availability: Fax lines open 24/7

Date: January 16, 2020 Attention: TCHP Providers Effective Date: January 6, 2020 Call to action: We are excited to announce that Texas Children’s Health Plan has made updates to the availability of the fax lines for authorization requests. The following outlines a summary of the changes. Beginning January 6, 2020, TCHP fax lines are open to receive requests for authorizations 24/7. This is a change to the former procedure to receive faxed requests for authorizations during normal business hours (Monday-Friday, 8a.m. – 6p.m.). Now [...]

Provider Alert!

Provider Alert! Authorization and Verification Process Updates

Subject:   Authorization and Verification Process Updates   Texas Children’s Health Plan (TCHP) has made updates to the authorization process. The following outlines a summary of the changes.   Individual Member Fax Requests To ensure Health Insurance Portability and Accountability Act (HIPAA) compliance, providers must send one fax request per member with each fax having its own cover sheet. Requests received with multiple members per fax will be returned to the provider and not processed.   Minimum Information Required to Process a Request *Providers must use the Texas Standard [...]