Tag - Verification

Provider Alert!
19Jul

Provider Alert! 2024 Annual Hospitals Standard Dollar Amount Verification

Date: July 19, 2023 Attention: Non-Rural and Non-State-Owned Hospital Providers Due date for the SDA Add-on Status Verification Form, if required: July 24, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers about the 2024 Annual Hospitals Standard Dollar Amount Verification. Background information: In accordance with Texas Administrative Code (TAC), §355.8052(d)(9), related to Medicaid Inpatient Hospital Reimbursement, hospitals may receive an annual standard dollar amount (SDA) adjustment based upon their trauma and/or safety-net designation. If qualified, hospitals may also...

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Provider Alert!
28Oct

Provider Alert! ANNOUNCEMENT: Member ID Cards

Dear Texas Children’s Health Plan providers, it has been brought to our attention that a small portion of our new members did not receive their current Member ID cards. We have already begun the process of sending the missing ID cards to members and will continue to do so until they are all properly distributed. We ask that you do not turn members away if they cannot present an ID card and instead utilize one of the following ways to...

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02Dec

Authorization and Verification Process Updates

Authorization and Verification Process Updates                                   Texas Children’s Health Plan has made updates to the authorization process. Individual Member Fax Requests To ensure Health Insurance Portability and Accountability Act (HIPAA) compliance, providers must send one fax request per member with each fax having its own cover sheet. Requests received with multiple members per fax will be returned to the provider and not processed. Minimum Information Required to Process a Request Providers must use the Texas Standard Prior Authorization Request Form*, which can be found at...

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01Oct

Authorization and Verification Process Updates

Texas Children’s Health Plan has made updates to the authorization process. Individual Member Fax Requests To ensure Health Insurance Portability and Accountability Act (HIPAA) compliance, providers must send one fax request per member with each fax having its own cover sheet. Requests received with multiple members per fax will be returned to the provider and not processed. Minimum Information Required to Process a Request Providers must use the Texas Standard Prior Authorization Request Form*, which can be found at https://www.texaschildrenshealthplan.org/for-providers. Click on Downloadable Forms...

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