Tag - STAR Kids

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! 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 [...]

May 30 CME “Autism — Not Just a Checklist”

Save the date Texas Children’s Health Plan Grand Rounds CME Series Autism – Not Just a Checklist Target Audience: Texas Children’s Health Plan contracted behavioral health providers. Educational methods will include lectures with question and answer sessions. This activity is approved for a maximum of 2.0 AMA PRA Category I Credit(s). Thursday, May 30, 2019 5:30 p.m. Registration and Dinner 6 p.m. Scientific Session Activity Director: Lia Rodriguez, MD, FAAP Medical Director, Texas Children’s Health Plan Speakers: Bob Voigt, MD Chief of Services, Developmental Pediatrics Director, Autism Center, Texas Children’s [...]

What does Service Coordination mean for your STAR Kids patients?

As a provider, you may have questions regarding the role Service Coordination plays in the lives of our STAR Kids members. At Texas Children’s Health Plan, the goal of Service Coordination is to optimize health to ensure that the member’s tomorrow is better than his or her today. Service Coordination is a person-centered approach to care and each of our members is assigned an appropriately licensed Service Coordinator. In order for that to happen, our Service Coordinators are responsible [...]

What is the Medically Dependent Children’s Program (MDCP) Waiver?

If you have STAR Kids patients, there’s a chance some of them receive the Medically Dependent Children’s Program (MDCP) waiver, which is a home and community based services program. The goal of this program is to support families and children by preventing institutionalization and hospitalization, while helping them remain safely in their homes with the appropriate services. Examples of these services include flexible family support service, respite, minor home modifications, adaptive aids, transition assistance services, employment assistance, supported employment, [...]

Dr. Katy Ostermaier joins Texas Children’s Health Plan as Medical Director for STAR Kids

This past fall, Texas Children’s Health Plan was thrilled to welcome Dr. Katy Ostermaier as the new Medical Director for STAR Kids. Dr. Ostermaier joins us from Texas Children’s Hospital, where she started the Special Needs Primary Care Clinic and served as the Clinic Chief for the Spina Bifida Clinic and the Down Syndrome Clinic. She completed medical school and her pediatric residency at Baylor College of Medicine, where she joined the faculty after completing her training. Dr. Ostermaier [...]

Provider Alert!

Provider Alert! STAR Kids Billing Requirements

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 [...]

Provider Alert!

Provider Alert! Adoption Assistance

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 [...]

Updated STAR Kids billing matrix effective June 5, 2017.

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 .