Tag - tmhp

Provider Alert!
04Apr

Provider Alert! New Prior Authorization Resource to Determine Dates of Service

Date: April 3, 2024 Attention: All Providers Call to action: The purpose of this communication is to inform providers of a new resource available from Texas Medicaid and Healthcare Partnership (TMHP) available at https://www.tmhp.com/topics/prior-authorization/pa-calculator.  It is included on the TMHP prior authorization webpage. Providers are encouraged to utilize this calculator to calculate the dates of service that must be applied to the prior authorization form/prior authorization request.  By accessing TMHP’s tool, providers will save time and avoid having to resubmit or correct authorizations...

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Provider Alert!
12Jan

Provider Alert! Update to Therapeutic Optometry Billing Services for CPT Code 65778

Date: January 12, 2023 Attention: Therapeutic Optometrists Effective: April 11, 2024 Call to action: Effective for dates of service on or after April 11, 2024, therapeutic optometrists are to bill with taxonomy code 152WV0400X (optometry vision therapy) when billing for placement of amniotic membrane on the ocular surface; without sutures, CPT code 65778. Next steps for providers: Providers should verify they are enrolled through Texas Medicaid & Healthcare Partnership (TMHP) under the therapeutic optometry taxonomy with code 152WV0400X in order for claims to process...

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Provider Alert!
21Nov

Provider Alert! Home Health Care Services (HHCS) Providers and FMSAs Must Submit EVV HHCS Claims to TMHP

Date: November 21, 2023 Attention: STAR Kids Providers/Consumer Directed Services employers and FMSA Providers Effective Date: December 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that the Home Health Care Services (HHCS) are found in the Programs, Services and Service Delivery Options Required to Use Electronic Visit Verification by Jan. 1, 2024 document.  The EVV HHCS Service Bill Codes Table is posted on the EVV 21st Century Cures Act web page in Excel and PDF formats.   Claims Submission On June 1, 2023, the Texas Medicaid & Healthcare Partnership...

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Provider Alert!
11Oct

Provider Alert! New Texas Medicaid & Healthcare Partnership (TMHP) Contracts

Date: October 10, 2023 Attention: All Providers Effective date: September 1, 2023 Call to action: The purpose of this communication is to inform providers that effective September 1, 2023 two new Texas Medicaid and Healthcare Partnership (TMHP) contracts went live: Accenture State Healthcare Services LLC (Accenture) is now the TMHP Business Operations and Business Integration (BusOps) vendor. The TMHP BusOps vendor acts as the project management office across the TMHP vendors and will manage the overall Medicaid ecosystem, including support services such as project management,...

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Provider Alert!
11May

Provider Alert! New EVV Vendor System HHAeXchange Launching October 1, 2023

Date: May 11, 2023 Attention: All Providers Effective Date: October 1, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that a new single state funded Electronic Visit Verification (EVV) vendor system, HHAeXchange, is launching October 1, 2023. On April 26, 2022, the Texas Health and Human Services Commission (HHSC) posted a solicitation for EVV System Management Services. Through a competitive selection process, HHSC has selected Accenture State Healthcare Services LLC. How this impacts providers: Accenture will continue to be known...

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Provider Alert!
27Apr

Provider Alert! UPDATE: Provider Enrollment and Management System (PEMS) Provider Guidance

Date: April 27, 2023 Attention: All Providers NEW Effective Date: June 30, 2023 Important provider notice: As a reminder, the Provider Enrollment and Management System (PEMS) is the required Texas Medicaid & Healthcare Partnership (TMHP) program which is the single tool for provider enrollment, reenrollment, revalidation, and maintenance requests (maintaining and updating provider enrollment record information) for Texas Medicaid. Accordingly, as an MCO, TCHP will contract, credential and pay only those providers who are properly enrolled with TMHP and whose information is received in...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
Provider Alert!
10Feb

Provider Alert! UPDATE: Provider Enrollment and Management System (PEMS) Provider Guidance

Date: February 10, 2023  Attention: All Providers National Provider Identifier (NPI) Master Provider file effective date: March 1, 2023 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. Important provider notice: As a reminder, the Provider Enrollment and Management System (PEMS) is the required Texas Medicaid & Healthcare Partnership (TMHP)...

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Provider Alert!
16Dec

Provider Alert! Correction to Rendering Provider Guidance Previously Provided

Date: December 16, 2022 Attention: All Providers   This communication is an update to the communication providedon November 23, 2022. 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: Please note this communication is a correction to the communication provided on November 23,2022. How this impacts providers: TCHP would...

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Provider Alert!
22Nov

Provider Alert! Reimbursement Rate Changes and Updates for Texas Medicaid Procedure Code 90461

Date: November 22, 2022 Attention: All Providers                 Subject: Effective date: September 1, 2022 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 make providers aware that the physician administered drug vaccines and toxoids administration procedure code 90461...

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Provider Alert!
28Jul

Provider Alert! Second Quarter 2022 HCPCS Updates for Texas Medicaid

Date: July 27, 2022 Attention: All Providers Effective Date: July 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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 providers that Texas Medicaid & Healthcare Partnership (TMHP) implemented the second quarter 2022 Healthcare Common Procedure Coding...

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