Tag - provider alerts

Provider Alert!

Provider Alert! Evrsydi available on Medicaid formulary with prior authorization requirements on Feb 1

Date: January 25, 2021 Attention: Neurologists and SMA specialists Effective Date: February 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: Prescribers should be aware that Evrysdi will be available to members through Texas Medicaid pharmacy benefit effective February 1. Access will require meeting clinical prior authorization criteria for Evrysdi (risdiplam).  Evrysdi is indicated for [...]

Provider Alert! COVID-19 Disaster Declaration – ALERT #5 – Prior Authorization Adjustments

Attention: All Providers Effective Date: February 22, 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. The content in this message is extended until March 31, 2021 except for 90-day authorizations which ended December 31, 2020 as announced by the Health and Human Services Commission. After January [...]

Provider Alerts! CHIP co-pays waived for office visits in response to COVID-19

Attention: All Providers Effective Date: February 22, 2021 The content in this message will remain in effect through March 31, 2021as announced by the Health and Human Services Commission. TCHP COVID-19 Utilization Management Procedure and provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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 [...]

Provider Alert! Provider enrollment re-validation due dates extended in response to COVID-19

Attention: All Providers Effective Date: February 22, 2021 The content in this message will remain in effect through March 31, 2021 as announced by the Health and Human Services Commission (HHSC). TCHP COVID-19 Utilization Management Procedure and provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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 [...]

Provider Alert! COVID-19 UPDATE ALERT #4 – Telemedicine Services – Physicians, BH, FQHC and RHC Providers

Attention: All Providers Effective Date: February 22, 2021 The content in this message on Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission. The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March 31, 2021 as [...]

Provider Alert! COVID-19 Guidance for FMSAs and CDS Employers

Attention: FMSA Providers Effective Date: February 22, 2021 The content in this message will remain in effect through March 31, 2021, as announced by the Health and Human Services Commission. COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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 [...]

Provider Alert: Guidance on Appeals and Fair Hearing Requests due to COVID-19

Attention: All Providers Effective Date: February 22, 2021 The content in this message on MCO Appeal Determinations expired on July 31, 2020. The remaining content will remain in effect through March 31, 2021 as announced by the Health and Human Services Commission (HHSC). TCHP COVID-19 Utilization Management Procedure and provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ Providers should monitor the Texas Children’s Health Plan Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or [...]

Provider Alert! Signature requirement waived on DME Forms due to COVID-19

Attention: DME Providers Effective Date: February 22, 2021 The content in this message will remain in effect through March 31, 2021, as announced by the Health and Human Services Commission. TCHP COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ TCHP network providers should monitor the 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 [...]

Provider Alert! The Texas Office of the Inspector General (OIG) extends deadlines due to COVID-19

Attention: All Providers Effective Date: February 22, 2021 The content in this message on Nursing Facility MDS Authorization Extensions will remain in effect through March 31, 2021 as announced by the Health and Human Services Commission. TCHP COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/ 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 [...]

Provider Alert! Texas Health Steps (THSteps) and CHIP medical checkups via remote delivery

Attention: All Providers and Pharmacies Effective Date: Dates of Service May 7, 2020 – March 31, 2021 The content in this message will remain in effect through March 31, 2021, as announced by the Health and Human Services Commission. TCHP COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/   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 [...]