Tag - provider alerts

Provider Alert!
13Apr

Provider Alert! Reminders: Prior Authorization Requirements and Qualifications for Urgent Requests

Date: May 5, 2021 Attention: All Providers Reminders: Prior Authorization Requirements and Qualifications for Urgent Requests 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 remind network providers of the prior authorization requirements and qualifications for urgent requests. How this...

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Provider Alert!
08Apr

Provider Alert! Changes to Hepatitis C Prior Authorization Criteria

Date: July 14, 2021 Attention: Primary Care Providers 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, Medicaid will expand coverage of the Hepatitis C virus clinical prior authorization criteria to include all metavir fibrosis scores. How this impacts...

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Provider Alert!
06Apr

Provider Alert! Update: New Edit Implemented by Claims Processor, Change HealthCare

Date: April 5, 2021 Attention: All Providers Effective Date: March 25, 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: This is an update to communication we previously posted: For network providers that have submitted institutional claims, (UB04 837I) from February 16, 2021 through March 25, 2021...

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Provider Alert!
06Apr

Provider Alert! Providers Must Update their Enrollment and Demographic Information with TMHP

Date: April 1, 2021 Attention: All Providers Effective Date: April 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) encourages network providers to update their enrollment and demographic information with Texas Medicaid Healthcare Partnership (TMHP) beginning April 1, 2021. TMHP...

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05Apr

Provider Alert! New Texas Department of State Health Services COVID-19 Vaccine Resource

Date: April 2, 2021 Attention: All Providers 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 would like to inform network providers of a new COVID resource available, the “Texas Public Health Scheduler”, to help people sign up for the COVID-19 vaccine...

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Provider Alert!
01Apr

Provider Alert! Prior Authorization Criteria for Zolgensma Updated

Date: April 22, 2021 Attention: Neurologists and SMA specialists Effective Date: May 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 of an update to prior authorization criteria for Zolgensma (onasemnogene abeparvovec) drug HCPCS code J3399.  Zolgensma is indicated for treatment of pediatric...

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Provider Alert!
31Mar

Provider Alert! New Online Provider Directory Platform

Date: July 12, 2021 Attention: All Providers Effective Date: May 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 our network providers that beginning May 1, 2021, there will be a new online provider directory platform....

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Provider Alert!
30Mar

Provider Alert! Genetic Testing Prior Authorization Requirement Reminder

Date: March 26, 2021 Attention: All Providers 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 remind network providers that all genetic testing requires an approved prior authorization before the laboratory tests can be completed. Quest Diagnostics is...

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22Mar

Provider Alert! COVID-19 Monoclonal Antibody Therapy Procedure Code Update

Date: July 19, 2021 Attention: All Providers Effective Date for Procedure code Q0244 is June 3, 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 would like to inform network providers that Texas Medicaid has revoked the Emergency Use Authorization (EUA) of...

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Provider Alert!
05Mar

Provider Alert! Prior Authorization Changes for Fasenra and Nucala

Date: February 19, 2021 Attention: Allergists & Immunologists, Pulmonologists Effective Date:  April 6, 2021 Call to action: Texas Children’s Health Plan (TCHP) is modifying prior authorization criteria for two monoclonal antibodies available through the pharmacy benefit: Fasenra (benralizumab) and Nucala (mepolizumab). Both are monoclonal antibodies approved for the treatment of severe asthma. The Texas Health and Human Services Commission (HHSC) revised the clinical prior authorization criteria for these agents to enhance appropriate utilization per the US Food and Drug Administration’s (FDA) approved indications and...

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