Provider Alert! Attention: Behavioral Health Providers and inpatient facilities

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

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.