Tag - provider alerts

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...

By Provider Alert, , , , , 0 CommentsRead more...
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...

By Provider Alert, , , 0 CommentsRead more...
Provider Alert!
26Nov

Provider Alert! Texas Department of State Health Services (DSHS) Laboratory Web Portal

On October 25th, it was reported that the laboratory web portal application for public health experienced unexpected technical difficulties. It is currently not available and as a result, the provider report cards are unavailable at this time. While DSHS Laboratory is actively working on a solution, there is not a date for when the matter will be resolved. How this impacts providers: Texas Health Step Providers that normally receive results via the Laboratory Web Portal will have the reports mailed to...

By Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
05Nov

Provider Alert! Syphilis testing laws updated effective 9/1/2019

Texas law now mandates three syphilis tests for all pregnant women: at the first prenatal exam, during the third trimester (no earlier than 28 weeks gestation), and at delivery.  This new testing is required because congenital syphilis cases reported to the Texas Department of State Health Services (DSHS) more than doubled last year.  There were 367 cases of congenital syphilis in Texas in 2018, up from 164 in 2017. The increase in reported cases is likely due to a combination...

By OB/GYNs, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
16Oct

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 in...

By Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
26Sep

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 provided...

By Provider Alert, , 0 CommentsRead more...
Provider Alert!
26Sep

Provider Alert! Initial specialty therapy evaluations no longer require an authorization but do require current Texas Health Steps checkup or attestation

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 impacts...

By Provider Alert, , , , 0 CommentsRead more...
Provider Alert!
25Sep

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 care...

By Provider Alert, , , 0 CommentsRead more...
Provider Alert!
16Sep

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 a...

By Provider Alert, , , , 0 CommentsRead more...
Provider Alert!
06Aug

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 later...

By Provider Alert, , , , , 0 CommentsRead more...