Provider Alert! Attention: Behavioral Health Providers and inpatient facilitiestcph
Attention: Behavioral Health Providers and inpatient facilities
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 network providers that we require all members receiving inpatient psychiatric services to be scheduled prior to discharge for outpatient follow-up and/or continuing treatment with a network behavioral health provider.
The timeframe requirements are as follows:
- Initial outpatient treatment after discharge must occur within seven (7) days from the date of discharge. The appointment should not occur on day of discharge.
- The second appointment after discharge must occur within thirty (30) days from the date of discharge.
- The appointment must be with a network psychiatrist, psychologist or therapist (LCSW, LPC, etc).
- Missed appointments must be rescheduled within twenty-four (24) hours.
- Due to appointment availability, it may be necessary to schedule the initial seven (7) day follow-up appointment with a therapist and continue treatment with the therapist until the psychiatric thirty (30) day follow-up appointment is met.
How this impacts providers: For access to our i-directory to search for TCHP network behavioral health providers, click here.
Incentive for STAR Kids Providers: Follow-up after Hospitalization for Mental Illness-7 Day (FUH-7DAY) – Mental Health Practitioner: STAR KIDS Members Only
- Minimal panel requirement: five (5) compliant members per payment period (6 months).
- Population: Members age 6 and older who were hospitalized for treatment of selected Mental illness or intentional self-harm diagnoses between 1/1/2021-12/31/2021.
- Incentive: $100.00 once per member age 6 years and older who was hospitalized for treatment of selected mental illness or intentional self-harm diagnoses and who had a follow-up visit with a mental health practitioner within 7 days of discharge during calendar year 2021.
Next steps for providers: Providers should share these requirements with their staff and members as discharge plans are being made and remind members of the following healthy rewards.
Behavioral Health Healthy Rewards/Value Added Services for Members 2020-2021
Mental Health Post Hospital Stay
Getting a follow-up after a mental health hospitalization is an effective way to avoid readmissions.
Members who qualify will receive a $25 reward card for completing a mental health follow-up visit with a behavioral health provider within 7 days of being discharged from the hospital.
Source: Mental Health Post Hospital Stay
If you have any questions, please email Provider Network Management at: providerrelations@t