Attention: STAR Kids Providers REMINDER: STAR Kids Billing Requirements As previously communicated, Texas Children’s Health Plan (TCHP) requires all STAR Kids providers billing for private duty nursing (PDN) services with the T1000 CPT code to use the billing matrix available on the Texas Health and Human Services website at https://hhs.texas.gov/laws-regulations/handbooks/star-kids-handbook/appendices/appendix-iii-ltss-billing-matrix-crosswalk. This requirement was effective June 5, 2017. Failure to use this billing matrix, including placement of modifiers, will result in denials for incorrectly billed services. Providers may receive line denials if [...]
Subject: Adoption Assistance Attention all Texas Children’s Health Plan providers: Effective 09/01/2017 Adoption Assistance members are required to enroll in managed Medicaid and will be new members with Texas Children’s Health Plan STAR or STAR Kids programs. For Continuity of Care, Texas Children’s Health Plan will receive authorizations from TMHP for Adoption Assistance services on Texas Children’s Health Plan members, effective September 1, 2017. Texas Children’s Health Plan will honor all existing authorizations until expiration or end of 90 days after [...]
Effective May 22, 2017, providers should fax prior authorization forms to 346-232-4757. The form can be found at http://www.texaschildrenshealthplan.org/for-providers/resources/downloadable-forms
Updated STAR Kids billing matrix effective June 5, 2017. Updates include: Registered nurse modifier (TD) to the private duty nursing (PDN) billing code, T1000 Billing codes for PDN independently enrolled LVNs and RNs are included in the matrix Revenue code 663 was added to the out-of-home respite codes. Please note that failure to use this billing matrix will result in denials for incorrectly billed services. For more information on this topic, visit http://www.texaschildrenshealthplan.org/for-providers .
As a reminder, members who have STAR and STAR Kids may change their managed care plans monthly. Providers should routinely verify eligibility with Texas Children’s Health Plan for membership by visiting our Texas Children’s Health Plan Provider portal at www.tchp.us\providers. The Provider portal has the most current information specific to Texas Children’s Health Plan. If you have questions regarding the Provider portal, please contact Texas Children’s Health Plan Provider Relations at 800-731-8527.
A Service Coordinator is the central contact between Texas Children’s Health Plan and a member’s providers and family members. The purpose of a Service Coordinator is to maximize a Member’s health, wellbeing and independence. The Service Coordinator must work with the Member’s PCP to coordinate all of a member’s health services. The STAR Kids Service Coordinator also engages as an advocate and intervenes on behalf of the member if approved by the member. The Service Coordinator will perform an overall [...]
Texas Children’s Health Plan recently opened its newest location in Tyler to serve the STAR Kids population in the northeast service area. A ribbon cutting ceremony at the office’s 100 East Ferguson in Tyler marked the grand opening of the satellite office. “We’re very excited to have the chance to serve families and their children with disabilities in Tyler and across Northeast Texas,” said Gail Bean, Provider and Care Coordination Regional Director. “We believe our long legacy and commitment to [...]
Over the past year and a half, the Texas Children’s Health Plan has been preparing for STAR Kids. This program will offer families with medically complex children the advantage of increased care coordination as part of Medicaid Managed Care. Some of the incredible numbers: 250+ new care coordinators hired and trained by Texas Children’s Health Plan 2,000 new providers added to our network 30,000 new members expected STAR Kids will offer providers additional support and help to reduce the many hassles we run [...]
What is STAR Kids? STAR Kids will be the first Medicaid managed care program in Texas specifically serving youth and children who get disability-related Medicaid. Texas Children’s Health Plan STAR Kids program will provide services, including long term support services (LTSS), for members ages 20 or younger who either receive Supplemental Security Income (SSI) Medicaid or are enrolled in the Medically Dependent Children Program (MDCP). Children and youth who receive services through other 1915(c) waiver programs will also receive their [...]