Monthly Archives - February 2023

Provider Alert!
28Feb

Provider Alert! CHIP State Plan Amendment Reducing Insulin Copays for Certain Members

Date: February 28, 2023 Attention: Primary Care Providers and Endocrinologists Effective date: June 1, 2023 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 copay charge for brand insulin drugs will be reduced beginning June 1, 2023 from $35 to $25 for CHIP members with incomes...

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Provider Alert!
22Feb

Provider Alert! Enfamil Prosobee Recall Information

Date: February 22, 2023  Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) received an urgent notice of Reckitt’s voluntary recall of two select batches of ProSobee plant-based infant formulas due to a possibility of cross-contamination with Cronobacter Sakazakii. TCHP wanted to ensure that our providers are aware of this important Member safety matter and are prepared to assist our Members in obtaining appropriate replacement formulas. Please inform Members DO NOT USE: Product: Enfamil ProSobee Powder, 12.9 oz Can Global Batch Code: ZL2HZF UPC: 300871214415 Lot...

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

Provider Alert! Asthma Reports Now Available on Texas Children’s Link, the Provider Portal

Date: February 21, 2023  Attention: Primary 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: TCHP is excited to share that we have added a NEW report to our Provider Portal. You can now locate your Asthma High Risk Reports on Texas Children’s Link....

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Provider Alert!
16Feb

Provider Alert! Changes to Lovaza Clinical Prior Authorization Scheduled for March 21, 2023

Date: February 15, 2023 Attention: Providers Effective Date: March 21, 2023 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 Texas Health and Human Services (HHS) will revise the Lovaza clinical prior authorization criteria guide to include any covered omega-3 fatty acids drugs. How this impacts providers: ●      The...

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

Provider Alert! Reimbursement Update for Procedure Codes Pending a Rate Hearing

Date: February 14, 2023  Attention: All Providers Effective date: May 8, 2023 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: Beginning May 8, 2023, TCHP will follow the Texas Medicaid Provider Procedures Manual (TMPPM) guidance regarding claims and the procedure codes that are pending a rate...

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14Feb

Provider Alert! COVID-19 UPDATE ALERT #4 – Telemedicine Services – Physicians, BH, FQHC and RHC Providers

Date: February 10, 2023 Attention: All providers  Effective Date: January 30, 2023 The content in this message on Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission. The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, Uncategorized, , 0 CommentsRead more...
13Feb

Provider Alert! Telemedicine/Telehealth claims guidance Provider Alert!

Date: February 10, 2023    Attention: All Providers Effective Date: January 30, 2023 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: TCHP supports the delivery of telehealth (non-physician-delivered) and telemedicine distant site services to its members. The purpose of this alert is to provide guidance on...

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13Feb

Provider Alert! Provider Alert! Guidance on Appeals and Fair Hearing Requests due to COVID-19

Date: February 10, 2023 Attention: All providers Effective Date: January 30, 2023 The content in this message will remain in effect through April 30, 2023 as announced by the Health and Human Services Commission (HHSC). 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 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...

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10Feb

Provider Alert! COVID-19 Vaccine Administration Procedure Codes 0164A and 0173A are Now Benefits of Medicaid and CHIP

Date: February 10, 2023  Attention: All Providers Effective date: Dates of service on or after December 8, 2022 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 for dates of service on or after December...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
10Feb

Provider Alert! UPDATE: Provider Enrollment and Management System (PEMS) Provider Guidance

Date: February 10, 2023  Attention: All Providers National Provider Identifier (NPI) Master Provider file effective date: March 1, 2023 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. Important provider notice: As a reminder, the Provider Enrollment and Management System (PEMS) is the required Texas Medicaid & Healthcare Partnership (TMHP)...

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