News Blog
31Oct

Provider Alert! All Texas Children’s Health Plan providers and facilities Utilization Management Guidelines effective November 1, 2016

Texas Children’s Health Plan has developed Utilization Management guidelines that serve as criteria for the determination of medical necessity for services that require prior authorization. These guidelines will be effective on November 1, 2016. The goal of Texas Children’s Health Plan’s Utilization Management guidelines is to encourage the highest quality care from the right provider in the right setting. Utilization Management guidelines are available for you to review. Please contact Texas Children’s Health Plan’s Provider Relations department at 832-828-1008 or toll-free at...

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28Oct

Provider Alert! Upcoming Texas Children’s Health Plan Provider TouCHPoint portal changes allows providers to submit claims electronically

In the coming weeks, Texas Children’s Health Plan will make available batch claims submission via the Texas Children’s Health Plan Provider TouCHPoint portal. This will be a free service to providers and will accept batch claims as well as appeals with supporting documentation. Please watch for more information posted on TCHP Provider TouCHPoint.

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25Oct

Upcoming Texas Children’s Health Plan Provider TouCHPoint portal changes: Provider Attestation required

The Texas Children’s Health Plan Provider portal is changing. In order to be compliant with HHSC guidelines to confirm provider demographic information, the Texas Children’s Health Plan Provider portal will require a quarterly attestation of information by NPI number. If access to the secure portal has been blocked because of needed attestation, users will not be able to access the portal until an office administrator for the account attests the information on file. Only staff with office administrator-level access can provide...

By Office Managers, Primary Care Providers, Specialists, , 0 CommentsRead more...
24Oct

Changes to the Sterilization Consent Form and Instructions, Approval Process, and Denial Letter

Changes to the Sterilization Consent Form and Instructions, Approval Process, and Denial Letter Information posted July 15, 2016 Note: This article applies to transactions submitted to TMHP for processing. For transactions processed by a Medicaid managed care organization (MCO), providers must refer to the MCO for information about benefits, limitations, prior authorization, and reimbursement. Effective September 1, 2016, the following changes will be made to the Sterilization Consent Form and corresponding instructions, the Sterilization Consent Form Denial Letter, and the process that providers...

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21Sep

Undescended Testicles and the Use of Ultrasound

Cryptorchidism or undescended testis (UDT) is the most common urological birth defect, occurring in 1 in 33 live male births. The most important reasons for surgical treatment of cryptorchidism include increased risks of testicular malignancy, infertility, testis torsion and/or inguinal hernia. The current standard of treatment for any UDT that fails to spontaneously descend by 6 months of age in the United States is orchidopexy (surgery to reposition the testis to the scrotum). Evaluation of UDT includes a thorough gestational...

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07Sep

THSteps Checkup Documentation — Essential to Medical Records

As a Texas Health Steps (THSteps) provider you affect the lives of many young Texans. The care you provide helps prevent serious or chronic health-care problems and often helps young patients begin to develop positive lifelong health-care habits. Being a THSteps provider can be very rewarding. It can also be very challenging, especially when it comes to medical checkup documentation. Independent studies of Texas Health Steps medical checkups indicate that records were most commonly missing documentation of appropriate laboratory tests...

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30Aug

Additional electronic payments offered with Virtual Credit Card option

You now have an additional payment option The Virtual Credit Card (VCC) has been made available through ChangeHealth, previously known as Emdeon. This option is available for all providers. VCC allows providers to accept a virtual payment instead of a paper check or electronic funds transfers. When you use VCC, providers will receive a unique 16-digit credit card number for every payment made by Texas Children’s Health Plan. That number is then keyed into your credit card terminal to receive...

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29Aug

Provider Alert! STAR Kids Provider Training Schedule

Beginning September 1, 2016, STAR Kids Provider Training will be offered in multiple locations, including the Harris, Jefferson and North East Medicaid service areas. Make your plans today to attend a training near you. Check our website for more details on training dates, locations, and registration. Click to Register for STAR Kids Provider Training

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19Aug

SBIRT: A validated practice to recognize teens who need help for substance abuse is a benefit of Texas Medicaid

A recent survey of pediatricians found that only a minority of pediatricians used validated screening tools for substance abuse screening, and most relied on clinical impressions. Studies have found that only one-third of adolescents excessively using alcohol were detected when pediatricians relied on clinical impressions. A revised policy statement and a new clinical report from the American Academy of Pediatrics (see additional resources below) contain updated guidance, including screening tools and intervention procedures in support of universal Screening, Brief Intervention...

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15Jul

Ensure the continuity of care for your teenage patients

During the transition from adolescence into adulthood, usually between the ages of 18 and 19, many Pediatric Primary Care Physicians inform their patients that they will no longer be able to serve as their Physician and ask them to secure a new Physician in an adult practice. After many years of being cared for by one Pediatric Physician, we recognize this can be an emotional time for everyone involved; however, Texas Children’s Health Plan is here to help. At Texas...

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