Provider Alert! CHIP co-pays waived for office visits in response to COVID-19

Date: September 29, 2022

Attention: All Providers

Effective Date: September 26, 2022

The content in this message will remain in effect through October 31, 2022 as announced by the Health and Human Services Commission.

TCHP COVID-19 Utilization Management Procedure and provider alerts can be found here: http://www.thecheckup.org/provider-alerts/

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: To help families in accessing care during the COVID-19 response, TCHP supports the Health and Human Services (HHSC) decision to waive office visit copayments for all CHIP members for services provided beginning on March 13, 2020 through October 31, 2022. Providers must not collect office visit copayments for CHIP members during this time.

How this impacts providers: The provider will be reimbursed by the member’s MCO the full rate for the service, including what would have been paid by the member through cost-sharing.

Next steps for providers:

• Providers must submit a completed template invoice with signed attestation for all office visit copayments not collected from members. The attestation must be submitted to TCHP by email to tchpfinance@texaschildrens.org and the deadline for receipt is November 30, 2022.
• TCHP has thirty (30) calendar days to pay the invoice received from a provider.
• In the situation that a provider has already collected a CHIP copay, a refund to the Member must be made before submitting to TCHP for reimbursement.

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org

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