Provider Alert! Reminder: Prior Authorization Form Completion
Date: February 13, 2024 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) supports the guidance from Texas Health and Human Services Commission (HHSC) on rejecting the Prior Authorization (PA) received with incomplete or insufficient documentation per Uniform Managed Care Manual (UMCM), Chapter 3.22. ‘Essential Information’ is the information required to initiate the PA review process, and are as follows: Member name Member number or Medicaid number Member date of birth Requesting provider name Requesting provider’s National Provider Identifier (NPI) Service requested – Current Procedural Terminology (CPT),...
