Author - tcph

Provider Alert!
25Jan

Provider Alert! Continuous Glucose Monitor and Integrated Insulin Pump Equipment Change for Texas Medicaid

Date: January 25, 2023 Attention: Primary Care Providers, Endocrinologists, and Diabetes Educators Effective date: January 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: Texas Children’s Health Plan (TCHP) would like to inform providers of new adjunct continuous glucose monitor (CGM) device and supply codes...

By Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
25Jan

Provider Alert! Site Verification Requirement for Texas Children’s Link

Date: January 25, 2023 Attention: Texas Children’s Link Site Administrators Completion date: March 6, 2023 or access will be denied 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: In order to protect patient privacy, every 6 months Texas Children’s requires that the Site Administrator for each...

By Office Managers, Provider Alert, 0 CommentsRead more...
Provider Alert!
23Sep

Provider Alert! ZZ Taxonomy Qualifier Requirement and Billing Taxonomy Reminder

Date: September 23, 2022 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 would like to provide guidance for the ZZ taxonomy qualifier and the billing taxonomy claims requirements. How this impacts providers: ZZ Taxonomy Qualifier: This communication is to notify providers...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
22Aug

Provider Alert! Coding Guidance for Identifying Members for Case Management

Date: August 22, 2022 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) has an extensive case management program available to our Members. To find out more information on this program, please see our provider manuals. While active Members...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
01Aug

Provider Alert! EVV Direction for FMSAs on CDS Employer Usage

Date: August 1, 2022 Attention: FMSA and Consumer Directed Services Employers Effective date: September 1, 2022 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. Call to action: The purpose of this communication is to inform Texas Children’s Health Plan (TCHP) financial management services agencies (FMSAs) and CDS...

By Provider Alert, Specialists, , 0 CommentsRead more...
Provider Alert!
29Jul

Provider Alert! Novavax COVID-19 Vaccine Coverage Update

Date: July 29, 2022 Attention: All Providers Effective date: July 13, 2022 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. Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that on July 13, 2022, the U.S. Food and Drug Administration (FDA) issued an emergency use...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, 0 CommentsRead more...
Provider Alert!
20Jul

Provider Alert! Approved in-office lab list

Date: July 20, 2022 Attention: All Providers Effective date for procedure code 83655, lead screening: June 22, 2021 Call to action: This alert is to serve as a reminder of the specific labs on our pre-approved list that may be run in a network provider’s office. How this impacts providers: Providers may perform specific point of care lab tests in their office and receive reimbursement from TCHP. All other lab tests should be referred to TCHP in network labs or State of Texas Laboratories....

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists0 CommentsRead more...
Provider Alert!
13Jul

Provider Alert! Removal of Specialist Requirements from CAD Clinical Policies and Prior Authorization Criteria

Date: July 13, 2022 Attention: Providers Effective Date: August 1, 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: HHSC is updating the prior authorization criteria for some clinician administered drugs. How this impacts providers: HHSC will no longer require the prescription include consultation with or be...

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Provider Alert!
13Jul

Provider Alert! All MCOs: Dupixent, Evrysdi, and Qelbree Clinical Prior Authorization Criteria Updates

Date: July 13, 2022 Attention: Providers Effective Date: August 2, 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: HHSC is revising the prior authorization (PA) criteria for the following drugs: Dupixent, Evrysdi and Qelbree. How this impacts providers: HHSC made the following revisions: Dupixent clinical PA criteria: Added...

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

Provider Alert! Removal of Specialist Requirements from CAD Clinical Policies and Prior Authorization Criteria

Date: July 13, 2022 Attention: Providers Effective Date: August 1, 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: HHSC is updating the prior authorization criteria for some clinician administered drugs. How this impacts providers: HHSC will no longer require the prescription include consultation with or be...

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