Monthly Archives - September 2020

Provider Alert!
29Sep

Provider Alert! Invoices Required for Manually Priced Laboratory Testing Claims Submissions

Attention: Laboratory Providers Effective Date: September 21, 2020 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: Laboratory providers submitting claims for COVID-19 testing or other services for a manually priced test must include the appropriate invoice(s) and documentation to ensure that manually priced laboratory claims...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
29Sep

Provider Alert! Limit increased for Code A4628, Oral Suction Catheter

Attention: All Providers Effective Date: September 22, 2020 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 inform providers that effective September 22, 2020 the limit for HCPCS Code A4628, oral suction catheter has been increased from two...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
29Sep

Provider Alert! Prior Authorization Update for Botulinum Toxin Benefits with Diagnosis Restriction

  Date: May 20, 2021 Attention: All Providers   Effective Date: May 18, 2021 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 remind providers of the prior authorization requirements for Botulinum Toxin effective October 1, 2020. A prior authorization...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
29Sep

Provider Alert! Texas Medicaid and CHIP Immunization Alert – Vaccines for Specific Ages

Date: September 29, 2020 Attention: All Providers 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: The Center for Disease Control and Prevention (CDC) recommends the following vaccines for children and adolescents.  Please refer to this guide when scheduling your patients’ annual well visit.   Ages Vaccines 4 Through...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
25Sep

Provider Alert! Prior Authorization Update for HCPCS Code H2011, Crisis Intervention

Attention: Behavioral Health Providers Effective Date: September 22, 2020 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) aligns with the prior authorization guidance available in the Texas Medicaid Provider Procedures Manual (TMPPM) for HCPCS Code H2011 Crisis Intervention, per 15...

By Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
24Sep

Provider Alert! Healthy Rewards/Value Added Services for 2020-2021

Attention: All Providers Effective Date: September 1, 2020 through August 31, 2021 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) is proud to present our Extra benefits/Value Added Services (VAS) program effective, September 1, 2020 through August 31, 2021....

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
21Sep

Provider Alert! Update: Substance Use Disorder (SUD) Service Code H0050 now requires a Prior Authorization and Authorization Reminders

Attention: Behavioral Health Providers    Effective Date: September 23, 2020 for Code H0050 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) aligns with the prior authorization criteria available in the most recent Texas Medicaid Provider Procedures Manual (TMPPM), Withdrawal Management Services....

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
15Sep

HEDIS Toolkit Offers Benefits to Providers

Members are cared for as HEDIS measures are met  Texas Children’s Health Plan developed a HEDIS Toolkit that contains helpful information regarding the measure requirements, standards and codes to use that are acceptable for HEDIS reporting. The new toolkit can be accessed here. This toolkit will serve as a reference form that can be used to code the type of appointments made and ensure that all of the HEDIS standards are met.  This will help providers maintain high quality care and meet...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , , , 0 CommentsRead more...
Provider Alert!
14Sep

Provider Alert! Screening and Coding for Social Determinants of Health – Introducing Texas Children’s Family Resources

Attention: Primary Care and Obstetric Care Providers 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: Are your patients struggling to meet their basic needs? Connect them today with Texas Children’s Family Resources to find food and housing assistance, help paying bills, and other free or reduced-cost...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
11Sep

Provider Alert! Guidance for Laxatives for Medicaid Members

Attention: All Providers Effective Date: September 3, 2020 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: Polyethylene Glycol [PEG] 3350 (generic for Miralax), ClearLax (powdered formulation of PEG 3350) and generic lactulose are all laxatives on the Texas Medicaid drug formulary. These agents are...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, Uncategorized, 0 CommentsRead more...