Monthly Archives - April 2021

Provider Alert!
28Apr

Provider Alert! FMSA Cost Survey

Date: April 28, 2021 Attention: Financial Management Services Agencies (FMSA) Due Date: May 19, 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 make FMSAs aware of a cost survey with an extended due date of May 19,...

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Provider Alert!
23Apr

Provider Alert! Peer to Peer Provider Authorization Communication

Date: April 23, 2021 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: Texas Children’s Health plan (TCHP) would like to make providers aware of the standard procedures when they receive a peer to peer letter for a denial or a partial denial...

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Provider Alert!
22Apr

Provider Alert! New Provider Type for Non-Local Mental Health Authority Providers of Mental Health Targeted Case Management/Rehab

Date: October 19, 2021 Attention: Billing Services for Behavioral Health Providers (Non-LMHAs) Subject: New Provider Type for Non-Local Mental Health Authority Providers of Mental Health Targeted Case Management/Rehab Deadline for provider enrollment: November 1, 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...

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Provider Alert!
20Apr

Provider Alert! Prior Authorization Update for Continuous Glucose Monitoring

Date: April 20, 2021 Attention: All Providers Effective Date: April 20, 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 would like to inform network providers that short-term continuous glucose monitoring service Procedure Codes 95250 and 95251 will require prior authorization effective...

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Provider Alert!
15Apr

Provider Alert! Update on Claim Submission Requirements for Institutional Claims

Date: April 8, 2021 Attention: All Providers Effective Date: April 16, 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 inform network providers that beginning April 16, 2021, Change Health Care (CHC) will require the following information on...

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Provider Alert!
14Apr

Provider Alert! Online Authorization Platform is Able to Accept Additional Clinical Information 

Date: April 8, 2021 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: Texas Children’s Health Plan (TCHP) would like to inform network providers that utilize our online authorization platform; Health Trio that this platform is now accepting additional clinical information once a...

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14Apr

Provider Alert! COVID-19 Vaccines Available and Administration

Date: June 30, 2021 Attention: All Providers Updated: May 18, 2021 with home health administration information 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 make network providers aware of the COVID-19 vaccines available through the pharmacy (retail)...

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Provider Alert!
13Apr

Provider Alert! Reminders: Prior Authorization Requirements and Qualifications for Urgent Requests

Date: May 5, 2021 Attention: All Providers Reminders: Prior Authorization Requirements and Qualifications for Urgent Requests 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 of the prior authorization requirements and qualifications for urgent requests. How this...

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Provider Alert!
08Apr

Provider Alert! Changes to Hepatitis C Prior Authorization Criteria

Date: July 14, 2021 Attention: Primary Care Providers Effective Date: September 1, 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: Effective September 1, 2021, Medicaid will expand coverage of the Hepatitis C virus clinical prior authorization criteria to include all metavir fibrosis scores. How this impacts...

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Provider Alert!
06Apr

Provider Alert! Update: New Edit Implemented by Claims Processor, Change HealthCare

Date: April 5, 2021 Attention: All Providers Effective Date: March 25, 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: This is an update to communication we previously posted: For network providers that have submitted institutional claims, (UB04 837I) from February 16, 2021 through March 25, 2021...

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