Tag - provider alert
18Mar

Provider Alert! Update – Telemedicine & Telehealth Services and COVID-19

Attention: All Providers Effective Date: March 17, 2020 Texas Children’s Health Plan supports the delivery of telemedicine and telehealth services to its members. As part of our COVID-19 Emergency Response, Texas Children’s Health Plan will add coverage of telemedicine services that are provided through only synchronous audio interactions (audio-only telephone consultation). How this impacts providers: Telemedicine services should be provided in compliance with standards established by the respective licensing or certifying board of the professional providing the services. While telemedicine services do not require...

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18Mar

Provider Alert! Reporting Provider Office Closures and Changes due to COVID-19

Attention: All Providers Effective March 17, 2020 Reporting Provider Office Closures and Changes due to COVID-19 The severity of the Coronavirus disease 2019 (COVID-19) may have affected your ability to operate during normal business hours. If your office has made any changes to the regular business operations or has closed entirely and unable to provide services to our members at this time, please complete an online questionnaire on our main website, https://www.texaschildrenshealthplan.org/for-providers. Be sure to include any changes to your office status and the...

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Provider Alert!
02Mar

Provider Alert! Prosthetics Codes Update

Effective Date: June 3, 2020 Attention: Prosthetics, DME providers, orthopedists, podiatrists, PCPs Call to action: Texas Children’s Health Plan will now configure the prosthetics procedures codes to require prior authorization according to the Texas Medicaid Provider Procedures Manual (TMPPM).  Currently, the only procedure codes on the prior authorization list are related to Breast Reconstruction. How this impacts providers: Provider offices should utilize the Standard Prior Authorization Form for prosthetics that require a prior authorization: https://www.texaschildrenshealthplan.org/for-providers/provider-resources/prior-authorization-information Next steps for providers: Providers should reference the prosthetic procedure...

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Provider Alert!
02Mar

Provider Alert! Provider Participation for Improved Texas Immunization Registry

Effective Date: February 28, 2020 Attention: Primary Care Providers Call to action: As you know, The Texas Immunization Registry, Immtrac2  manages the records for patients and makes them accessible for national and local stakeholders alike. Locally, school districts utilize Immtrac2 for eligibility when students enroll. It is important to ensure quality data is maintained and available so all health care providers have the ability to provider better and more reliable care. To achieve this, it is important that providers are active members...

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Provider Alert!
26Feb

Provider Alert! Updated Wheelchair Guidelines

Call to action: The purchase of a wheelchair is a benefit every five years, with the following guidelines: For current members who are twelve years of age and younger: The wheelchair frame must allow for at least a 3-inch growth potential in both width and depth. For current members who are 13 through 17 years of age: The wheelchair frame must allow for at least a 2 inch growth potential in both width and depth. For current members who are 18 years of...

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03Feb

Provider Alert! Novel Coronavirus Infection – Continued Updates

Date: 2/3/2020 TCHP wants to help keep you up-to-date on developing issues.  Because updates are coming so frequently about the new coronavirus, please look for our posts on TheCheckup.org where you’ll find the latest information.  Also check with your institutional leaders to see if they have developed specific protocols for infection control. A new coronavirus (2019-nCoV) was recently detected in Wuhan City, China and is causing an outbreak of respiratory illness. The 2019-nCoV outbreak began in December 2019, and Chinese health officials...

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Provider Alert!
03Feb

Provider Alert! Mandatory HHSC training for Financial Management Services Agencies (FMSA)

Effective February 25, 2020 Call to action: Health and Human Services Commission (HHSC) is providing a webinar for Financial Management Services Agencies (FMSAs) scheduled for Tuesday, February 25th, beginning at 1:30 P.M until 3:00 P.M. How this impacts providers: All FMSAs currently contracted with MCOs or HHSC must attend this training. Next steps for providers: FMSA providers should register for the training at: https://register.gotowebinar.com/register/2102807596481100801 The topics covered in the webinar will include: Consumer Directed Services updates and reminders Electronic Visit Verification updates Texas Workforce Commission updates   If you...

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Provider Alert!
29Jan

Provider Alert! URGENT – Makena (hydroxyprogesterone caproate) formulary change

Attention: OB providers Subject: URGENT - Makena (hydroxyprogesterone caproate) formulary change Effective Date: January 30, 2020   Call to action: The Texas Vendor Drug Program (VDP) will implement changes to the state Medicaid drug formulary, effective Thursday, January 30, 2020. Brand Makena formulations (intramuscular solution for injection, and subcutaneous auto-injectors) will remain on the preferred drug list (PDL). VDP has moved all generic hydroxyprogesterone caproate formulations to non-preferred drug status. Compounded formulations are not covered under the Medicaid formulary. Medicaid managed care plans are required...

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Provider Alert!
17Jan

Provider Alert! Medicaid drug formulary changes effective 1/30/2020

The Texas Vendor Drug Program (VDP) will implement changes to the state Medicaid drug formulary, effective Thursday, January 30, 2020. Select medications will be moving from “preferred” to “non-preferred” status and vice-versa. Texas Children’s Health Plan wanted to notify you in advance so that these changes do not impact the ability of your patients to obtain their medications.  A summary of the changes is included below.   Preferred and non-preferred medications may continue to require clinical prior authorizations. In addition to any...

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Provider Alert!
17Jan

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 providers...

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