Tag - claims

Provider Alert!

Provider Alert! Reminder of Updated Rendering Provider Edit Requirements

Date: November 10, 2022 Attention: All Providers Effective Dates: June 21, 2022 for rendering edit requirements Further clarification provided: November 10, 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 the nature of the COVID-19 Event. Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers of billing requirements for [...]

Provider Alert!

Provider Alert! Telemedicine/Telehealth claims guidance

Date: October 3, 2022 Attention: All Providers Effective Date: September 26, 2022 Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission. The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March 31, 2022 as announced by the [...]

Provider Alert!

Provider Alert! Updated Rendering Provider Edit Requirements

Date: August 12, 2022 Attention: All Providers Effective Dates: June 21, 2022 for rendering edit requirements overall September 6, 2022 for new exemptions 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 new billing requirements for [...]

Provider Alert! Updated Age Range for COVID-19 Vaccine Administration Procedure Code M0201

table { border-collapse: collapse; }tr,td { border: solid thin; } Date: May 4, 2022 Attention: All Providers Effective date: Dates of service on or after October 29, 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. TCHP will apply updates and reprocess impacted claims as soon as possible. [...]

Provider Alert!

Provider Alert! Provider Portal Provides Instant Access to Claims and Member Information

Date: April 22, 2022  Attention: All Providers 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 required to appeal claims unless [...]

Provider Alert!

Provider Alert! Retrospective Review of Paid Claims with Electronic Visit Verification (EVV) Claims Matching

Date: September 10, 2021 Attention: STAR Kids Providers/Personal Care Services & FMSA Providers Effective Date: September 10, 2021 Call to action:  In alignment with HHSC requirements, Texas Children’s Health Plan will begin a review of paid claims that require a matching EVV transaction for dates of service March 21, 2020 – December 31, 2020. Claims that were bypassed under the “EVV007 – Match Not Required” exception were granted 180 days to complete the necessary visit maintenance. This time period has now lapsed. [...]

Provider Alert!

Provider Alert! Rendering Provider Edit Requirements

table { border-collapse: collapse; }tr,td { border: solid thin; } Date: March 23, 2022 Attention: All Providers Effective Date: June 21, 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. Regarding system configuration updates, TCHP will apply updates and reprocess impacted claims as soon as possible. However, due to [...]

Provider Alert!

Provider Alert! Provider Claims Appeal Report now offers a Status Update on the Provider Portal

Date: September 20, 2021 Attention: All Providers Effective Date: September 9, 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: A new enhancement for the provider portal claims appeal report includes a status update for appeals submitted September 9, 2021 or later. How this impacts providers: [...]

Provider Alert!

Provider Alert! Update on Claim Submission Requirements for Institutional Claims

Date: April 8, 2021 Attention: All Providers Effective Date: April 16, 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 April 16, 2021, Change Health Care (CHC) will require the following information [...]

Provider Alert!

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

Date: April 5, 2021 Attention: All Providers Effective Date: March 25, 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: This is an update to communication we previously posted: For network providers that have submitted institutional claims, (UB04 837I) from February 16, 2021 through March 25, [...]