Tag - provider alert

Provider Alert!

Provider Alert! Dupixent (dupilumab) Criteria Update

Date: December 7, 2021 Attention: Primary Care Providers and Pulmonologists Subject: Dupixent (dupilumab) Criteria Update Effective Date: October 20, 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: Effective October 20, 2021, Texas Medicaid revised criteria of the Dupixent (dupilumab).  Dupixent is FDA-approved as an add-on maintenance...

Provider Alert!

Provider Alert! JW Modifier Update

Date: November 18, 2021 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...

Provider Alert!

Provider Alert! Chantix (Varenicline) Tablets Voluntary Recall

Date: September 22, 2021 Attention: All Providers and Pharmacies Effective Date: September 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: Pfizer has issued a voluntary recall of all lots of CHANTIX (Varenicline) Tablets. Potentially impacted customers were notified with a recommendation to not stop...

Provider Alert!

Provider Alert! 2021-2022 Respiratory Syncytial Virus Season and Synagis (palivizumab)

Date: July 23, 2021 Attention: All Providers Treatment start date: October 1, 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. **This notice may be updated as new regions are opened or closed Call to action: The traditional 2021-22 Respiratory Syncytial Virus (RSV) season is here! The Texas RSV Region...

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: The...

Provider Alert! COVID-19 Vaccine Administration Procedure Code M0201 is Now a Benefit

Date: September 20, 2021 Attention: All Providers Effective Date: Dates of service on or after June 8, 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: Effective for dates of service on or after June 8, 2021, COVID-19 vaccine administration add-on procedure code M0201 is now...

Provider Alert!

Provider Alert! Hurricane Ida Information for Medicaid Providers

Date: August 30, 2021 Attention: All Providers Effective Date: August 28, 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 providers rendering services to evacuees from Louisiana due to Hurricane Ida may complete the Hurricane Emergency Expedited Application with Louisiana Medicaid to receive reimbursement for...

Provider Alert!

Provider Alert! Subcutaneous Internal Cardiac Defibrillator (S-ICD) to Become a Benefit for Texas Medicaid

Date: August 25, 2021 Attention: Cardiologists Effective Date: September 1, 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: Effective September 1, 2021, subcutaneous internal cardiac defibrillator (S-ICD) procedure codes 33270, 33271, 33273, 33274, 93287, and 93290 will become a benefit for Texas Medicaid. How this impacts...

Provider Alert!

Provider Alert! Vision Services-Nonsurgical Benefits to Change

Date: August 25, 2021 Attention: Optometrists and Ophthalmologists Effective Date: September 1, 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: Effective September 1, 2021, Texas Children’s Health Plan(TCHP) will implement the Vision Services benefit changes outlined in the TMHP Bulletin Vision Services-Nonsurgical Benefits to Change...

Provider Alert!

Provider Alert! Therapy Prior Authorization Update

Date: July 29, 2021 Attention: All Providers Effective Date: August 1, 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 providers of updated TCHP prior authorization requirements for therapy services. How this impacts providers: Requests for acute therapy...