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 .
The Health and Human Services Commission (HHSC) expects managed care organizations to extend longterm services and supports (such as Personal Care Services, Community First Choice, and Private Duty Nursing) authorizations for services until completion of the STAR Kids Screening and Assessment Instrument (SAI), but no longer than July 1, 2017. In compliance with HHSC’s guidance and as required by the STAR Kids contract, STAR Kids managed care organizations must assess each enrolled member by completing the STAR Kids Screening and Assessment...
Attention STAR Kids Providers Texas Children’s Health Plan New Fax Number for STAR Kids Private Duty Nursing Prior Authorization To expedite the prior authorization process for Texas Children’s Health Plan for STAR Kids, please begin faxing to 346-232-4757 for outpatient prior authorization for the following service. Private Duty Nursing The Prior Authorization Request Form is conveniently located on the STAR Kids website at http://www.texaschildrenshealthplan.org/sites/default/files/pdf/20150410_Standard%20Prior%20Auth%20Form.pdf. Please contact your dedicated Provider Service Representative toll-free at 1-800-731-8527 with any questions. Thank you for your commitment to your Texas Children’s Health...
Attention STAR Kids Providers Effective 06/05/2017 Updated STAR Kids Billing Matrix The STAR Kids billing matrix has been updated to include the registered nurse modifier (TD) to the private duty nursing (PDN) billing code, T1000. Additionally, the billing codes for PDN independently enrolled LVNs and RNs have been added to the matrix. The Revenue Code 663 was added to the Out-of-Home Respite codes. This billing matrix will become effective for dates of service June 5, 2017 and forward. Failure to use this...
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.
PRESCRIPTION PRIOR AUTHORIZATION NOTIFICATION Subject: STAR Kids Prescription/Pharmacy Prior Authorizations Reinstated 4/15/17 Effective 4/15/17, Texas Children’s Health Plan (TCHP) will enforce pharmacy prior authorization (PA) requirements for STAR Kids members STAR Kids members who received a prescription between 11/1/16-4/15/17 were not subject to normal PA requirements. PA requirements were temporarily lifted during this period to help facilitate the transition to STAR Kids. After 4/15/17, all prescriptions for STAR Kids members will be subject to normal PA documentation, including non-preferred drugs and drugs that require...
Attention Long Term Services and Supports Providers Texas Children’s Health Plan would like to ensure that we have received all your claims from November 1st 2016, the program start date for STAR Kids. If you should have any questions related to claim submission and/or billing requirements, please contact Provider Relations at 1-800-731-8527. Your Provider Relations team is prepared to guide you through the billing standards necessary to accurately bill Texas Children’s Health Plan and receive your payments timely. The Texas Children’s Health Plan...
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 evaluation...
Attention: All STAR Kids Providers February 1st 2017 Subject: Reminder on ability to bank respite hours for MDCP members Texas Children’s Health Plan would like to remind all STAR Kids providers who are providing respite care to members of the standards around respite care hours and how Texas Children’s Health Plan manages these hours. The information below is directly from HHSC and is the guidance Texas Children’s Health Plan follows for determining respite care. Please always contact either Texas Children’ Health Plan’s...
