Tag - provider alert

Provider Alert!

Provider Alert! Subject: Codes: K0108, A9900, and E1399 Wheelchair Guideline

Attention: All Providers Effective Date: October 22, 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. In follow-up to our Provider Alert posted on 7/13/2020 regarding wheelchair accessories, Texas Children’s Health Plan did not implement changes to the current process for prior authorization of codes:  K0108, A9900, and [...]

Provider Alert!

Provider Alert! Texas Children’s Health Plan Special Investigations Unit and Claims Payment Review Information

Attention: All Providers Effective Date: October 23, 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 share information with our provider network on two important topics, the Special Investigation Unit and Claims Payment Reviews. What is the [...]

Provider Alert! Texas Children’s Health Plan to host live CME Event

Paying Attention to ADHD: Diagnosis, Treatment & Resources  Texas Children’s Health Plan is hosting a new CME: Paying Attention to ADHD: Diagnosis, Treatment & Resources. This is a free CME for contracted family practice and pediatric providers that will offer two course credits   Thursday, October 29, 2020 – 5:30-7:30 p.m. – Live stream via WebEx   Topics covered will include: Diagnosis and treatment of ADHD Community supports & resources Pharmacy navigation with the state formulary What is CPAN [...]

Provider Alert!

Provider Alert! Attention: NCQA HEDIS Measure Changes

Attention: PCP, OB/GYN and Endocrinologist Providers Effective Date: January 1, 2020 Call to action: Texas Children’s Health Plan (TCHP) would like to inform you of changes to the National Committee for Quality Assurance (NCQA) HEDIS Technical Specifications released on July 1st, 2020. How this impacts providers: These changes are effective as of January 1, 2020. Please submit all claims timely, as soon as services are rendered, and use appropriate codes to reflect the services provided particularly for Well-Care Visits and THSteps. REVISED MEASURES Well-Child Visits [...]

Provider Alert!

Provider Alert! Single-Dose Vial Unused Portion Reimbursement Policy for Clinician-Administered Drugs

Attention: All Providers Effective Date: September 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) aligns with Texas Medicaid and Healthcare Partnership (TMHP) regarding the reimbursement policy for the unused portion of a single use vial for clinician-administered [...]

Provider Alert!

Provider Alert! Prior Authorization Guideline updates for Private Duty Nursing (PDN) and therapy specialty services

Attention: All Providers Effective Date: July 18, 2020 for PDN and August 11, 2020 for therapy Services 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 recent updates to the prior authorization requirements and the effective dates. Updates [...]

Provider Alert!

Provider Alert! Uniform Opioid Policy Begins September 1

Attention: All Providers Effective Date: September 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: Effective September 1, 2020, the Vendor Drug Program (VDP) will implement a uniform opioid policy to encourage appropriate use and reduce opioid over-prescribing. The opioid policy does not apply to chronic pain, [...]

Provider Alert!

Provider Alert! Generic Albuterol Products Return to Non-Preferred Status for Medicaid Members

Attention: All Providers Effective Date: August 28, 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: Beginning August 28, 2020 the Texas Vendor Drug Program (VDP) will restore non-preferred status to a number of generic albuterol products. VDP temporarily removed nonpreferred status from these [...]

Provider Alert!

Provider Alert! Preferred Generic Stimulant Available on the TX Medicaid Formulary

table { border-collapse: collapse; } tr,td { border: solid thin; } Attention: All Providers Effective Date: July 30, 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: Effective Thursday, July 30, 2020, the Texas Vendor Drug Program (VDP) updated [...]

Provider Alert!

Provider Alert! Prior authorization update for Reblozyl, procedure code J0896

Attention: Hematologists Effective Date: September 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) will align the prior authorization requirements for Reblozyl with Texas Medicaid Healthcare Partnership (TMHP) guidance. A prior authorization will be required beginning September 1, [...]