Monthly Archives - October 2017

27Oct

HEDIS Spotlight: Chlamydia and cervical cancer screenings

HEDIS stands for Healthcare Effectiveness Data and Information Set. It is a widely used set of performance measures by the nation’s health plans, and an essential tool in ensuring that our members are getting the best healthcare possible. It is extremely important that our providers understand the HEDIS® specifications and guidelines. In this section of The Checkup we will highlight different HEDIS metrics. We will provide a description of the measures, the correct billing codes to support services rendered, and...

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25Oct

Flu is back – vaccinate now!

Flu season is back and the flu vaccine continues to be the best way to protect ourselves and our patients against serious complications from the flu. The more people who get vaccinated, the more we can prevent influenza from impacting those who are most vulnerable to complications. In 2017, a study in Pediatrics was the first of its kind to show that flu vaccination also significantly reduced a child’s risk of dying from influenza. What’s new for flu in 2017-2018? Recommendation to not use...

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21Oct

Appointment availability standards

What are appointment availability standards? How do you as a provider with Texas Children’s Health Plan play a role? In 2015 Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines. AFTER HOURS: Primary Care Physicians Accessible 24 hours a day, seven days a week, must return call...

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17Oct

Provider Alert! Zika Care Connect

This notification is intended to encourage providers to enroll in Zika Care Connect (ZCC), a voluntary program to connect pregnant women and infants affected by Zika to recommended healthcare services. This program establishes a network of specialty healthcare professionals, called the ZCC Healthcare Professional Network. It includes individual providers and coordinated care centers, and was established based on clinical guidance developed by the Centers for Disease Control and Prevention (CDC). Given your affiliation as a Medicaid provider, you may be interested in...

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15Oct

Save the Date! Register for the November 18 CME Session

Grand Rounds CME Series Parent Management Training Workshop: Evidence-based Therapy Guidelines for Disruptive Behaviors Speaker: Marni Axelrad, PhD – Psychologist, Baylor College of Medicine – Houston, TX Saturday, November 18, 2017 8:30 a.m. Registration & breakfast 9 a.m. – 12 p.m. Workshop Location: UT Health Cooley Center 7440 Cambridge St, Houston, TX 77030 Register online now at TexasChildrensHealthPlan.org/CME Free registration for Texas Children’s Health Plan Contracted Providers

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11Oct

Upcoming Electronic Visit Verification (EVV) training sessions

Houston Date: November 7 & 8, 2017 The same information will be covered on both days, so providers only need to attend one session. Time: 9:00am – 4:00pm Location: Texas Children’s Hospital, The Woodlands Campus, 17580 Interstate 45 South, The Woodlands, TX 77384   Irving When: December 5 & 6, 2017 The same information will be covered on both days, so providers only need to attend one session. Time: 9:00am – 4:00pm Location: The Innovator’s Auditorium, 1660 N Westridge Drive Irving, TX 75038   Click here for more information

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02Oct

Antivirals and the flu: know when the time is right

Antiviral medications play a role in treating influenza, but they are not a substitute for vaccination. According to CDC recommendations, all patients at high risk for complications who appear to have influenza should be considered for early antiviral treatment, independent of laboratory confirmation or influenza vaccine status. This approach can help reduce morbidity and mortality, particularly in young children and those who have underlying co-morbidities. Clinical trials and observational data show that early antiviral treatment can shorten the duration of...

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