Tag - provider alerts

Provider Alert!

Provider Alert! Reimbursement Rate Changes for PCS, PDN & Therapy Services

Date: October 16, 2019 Attention: Home Health, Therapy and LTSS Providers Subject: Reimbursement Rate Changes for PCS, PDN & Therapy Services Effective Date: September 1, 2019 Call to action: On August 28, 2019, Texas Children’s Health Plan (TCHP) received notice of the rate changes from Texas Medicaid Healthcare Partnership (TMHP) effective September 1, 2019.  The services impacted by the Medicaid-implemented rate changes include: Personal Care Services (PCS) Private Duty Nursing (PDN) Therapies for Children in the Home Therapy Assistants TCHP is in the process of implementing the updates [...]

Provider Alert!

Provider Alert! Information for Members on Recent Storm

Dear Providers, The services you provide to our members are important and during this time of inclement weather, we want to make accessing health care as easy as possible. Please find important details to assist you below.  This information only applies to members located in the impacted counties as outlined. Impacted Counties:  Brazoria, Chambers, Galveston, Hardin, Harris, Jasper, Jefferson, Liberty, Matagorda, Montgomery, Newton, Orange, and San Jacinto Important Things to Know: Prior authorizations are waived for medically necessary procedures and treatments including service [...]

Provider Alert!

Provider Alert! Amended: Initial and Ongoing Specialty Therapy Treatment

Date: September 19, 2019 Attention: All Providers Subject:  Amended:  Initial and Ongoing Specialty Therapy Treatment- Current Texas Health Steps Checkup or Attestation required Effective Date: September 19, 2019 Call to action: Initial specialty therapy (occupational, physical, speech therapy) evaluations do not require prior authorization effective September 1, 2019. However, a current Texas Health Steps checkup performed in the last 12 months or a current well checkup attestation is required for ongoing specialty therapy lasting for greater than 60 days. How this [...]

Provider Alert!

Provider Alert! Reporting Provider Office Closures due to Recent Storm

Dear Providers, The severe weather experienced recently may have affected your ability to operate during normal business hours.  If you are unable to provide services to our members at this time, please contact us via the Provider Portal Message Center and select the “General Health Plan Questions” as the recipient.  Be sure to include any changes to your business hours and/or location and the TCHP Provider Network Management Department will follow-up with you. Thank you for your continued support and the [...]

Provider Alert!

Provider Alert! Smoking Cessation Benefits

Call to action: This notice is regarding the risk of severe lung disease among individuals who vape. Providers are reminded that screening and information on smoking cessation should be included as part of any routine patient visit.  In addition to the services and support available through CHIP and Medicaid Texas Children’s Health Plan offers value added smoking cessation benefits to its active members. How this impacts providers: Providers should educate susceptible patients presenting with respiratory symptoms or other related health [...]

Provider Alert!

Provider Alert! Respite Care Services

Call to action: Texas Children’s Health Plan (TCHP) offers a respite care value-added service for STAR Kids members.  Respite care provides temporary relief for parents or legally authorized representatives who are caring for a child with special needs.  TCHP offers 24 hours of in-home respite care service per calendar year as an extension of home and community-based services. How this impacts providers: This value-added service applies to TCHP STAR Kids members that are not already receiving respite care services through [...]

Provider Alert!

Provider Alert! : Initial Specialty Therapy Evaluations no longer require an Authorization

Effective Date: September 1, 2019 Call to action: Initial specialty therapy (occupational, physical, speech therapy) evaluations do not require prior authorization effective September 1, 2019. How this impacts providers: In an effort to ensure our in-network providers can provide specialty therapy evaluations within 21 days of submission of a signed referral, Texas Children’s Health Plan (TCHP) will no longer require prior authorization for in-network specialty therapy evaluations billed within the guidance of the current Texas Medicaid Provider Procedure Manual (TMPPM). Next steps for [...]

Provider Alert!

Provider Alert! TMHP EVV Prospective Process

Attention: All TCHP STAR Kids LTSS Providers Requiring EVV Subject: TMHP EVV Prospective Process Effective Date:  Effective 9/01/2019, the Texas Health and Human Services Commission (HHSC) will implement their new EVV claims matching process. Claims with a date of service on 9/01/2019 or later will be required to be sent to the Texas Medicaid & Healthcare Partnership (TMHP) for claims matching. After this date, all claims submitted directly to Texas Children’s Health Plan with a date of service on 9/01/2019 or [...]

Provider Alert!

Provider Alert! Mandatory HHSC Webinar Training

7/23/2019 Attention: Financial Management Services Agencies (FMSA) HHSC is providing a webinar training for financial management services agencies (FMSAs). All FMSAs currently contracted with MCOs or HHSC must attend this mandatory training. When: Monday, July 29th at 1:30 p.m. Where: Online webinar, Register here: https://register.gotowebinar.com/register/6419407779512242946 What to expect: Consumer Directed Services (CDS) updates and reminders EVV updates   NOTE: Go to https://support.logmeininc.com/gotomeeting/get-ready  to run a test of your computer’s connectivity if you have never attended a Webinar from your computer. You can run this test at any time prior to the [...]

Provider Alert!

Provider Alert! TCHP Prior Authorization Requirements

Date:  July 1, 2019 Subject: TCHP Prior Authorization Requirements Effective October 1, 2019, TCHP has updated the prior authorization listing. Please note there are some key changes for providers.   Added:            Case by Case Added Services This category includes CPT/HCPCS codes that are listed as not payable in the TMHP fee schedule. Clinician Administered Drugs that Require Authorization Please refer to the Prior Authorization Reference Information document for specific codes that fall under this category. This document can be found at: https://www.texaschildrenshealthplan.org/for-providers/provider-resources   DME Repair [...]