OB/GYNs – Page 60 – The Checkup

Articles with relevant information for OB/GYNs

15AugAugust 15, 2017

LARCs during the postpartum period

In order to maximize the time before termination of Medicaid coverage for pregnant women, we recommend scheduling the postpartum visit at 3 to 5 weeks after delivery. This allows sufficient time to bring the patient back for Long-acting Reversible Contraception (LARC) insertion before termination of benefits and after the postpartum visit has been completed. For LARCs, the provider will bill for both insertion of the device and the device itself. The date of the insertion and the date of the device...

By Texas Children's Health PlanOB/GYNsbilling, LARC, LARC Toolkit, Postpartum0 CommentsRead more...

14AugAugust 14, 2017

Appointment Availability Standards

What are appointment availability standards? How do you as a provider with Texas Children’s Health Plan play a role? In 2015 Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines. Provider Type Level/Type of Care Appointment Accessibility Standards OB/GYN Low Risk Pregnancies Provided within 14 calendar days High Risk Pregnancies Offered within 5 calendar...

By Texas Children's Health PlanOB/GYNs, Primary Care ProvidersAppointments, Availability0 CommentsRead more...

25JulJuly 25, 2017

New claim appeal form

New claim appeal form can be found at http://www.texaschildrenshealthplan.org/for-providers/resources/downloadable-forms Please note that providers must file an appeal within 120 days from the date of the denial for reconsideration.

By Texas Children's Health PlanOB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialistsappeals, claim, claim appeal, forms0 CommentsRead more...

12JunJune 12, 2017

Texas Becomes 4th State to Launch Universal Baby Box University Program to Equip New Parents to give their Babies a Healthy Start in Life

Encourage your patients to be a part of the Baby Box movement, which promotes safe sleep for infants! Texas has become the 4th state to launch Baby Box University, which helps new parents give their babies a healthy start in life. The Baby Box program is designed to encourage mothers to get prenatal care and promote a good relationship between moms-to-be and their doctors. By completing an online syllabus through the company’s educational platform, Baby Box University, all new and expecting...

By Texas Children's Health PlanOB/GYNsbabies, Baby Box, Newborn, OB0 CommentsRead more...

24MayMay 24, 2017

The Texas Clinician’s Postpartum Depression Toolkit

A new resource for screening, diagnosis and treatment of postpartum depression. Click here to view this helpful resource for postpartum depression: http://www.texaschildrenshealthplan.org/sites/default/files/pdf/the_texas_clinicians_postpartum_depression_toolkit%20FINAL.pdf

By Texas Children's Health PlanOB/GYNsBehavioral Health, Depression, OB, Postpartum, pregnancy0 CommentsRead more...

17MayMay 17, 2017

TCHP now accepts Outpatient Authorizations for many services online via Clear Coverage effective June 1, 2017!

Tired of faxing authorization requests and medical records? Spending too much time on hold waiting to speak to an Authorization Specialist for non-urgent authorization request? Looking for a faster, more efficient way to submit authorizations? Why not submit your authorizations request through Clear Coverage? What are the benefits? Easy to access 24/7 online access to Clear Coverage Receive real time authorization status by viewing your office’s home page in Clear Coverage Services are immediately uploaded into Texas Children’s Health Plan’s authorization for clinical review Automatic APPROVALS may be...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsAuthorization, Authorizations, Clear Coverage, Outpatient0 CommentsRead more...

17MayMay 17, 2017

Provider Alert! Authorization Extension for STAR Kids Members

Attention STAR Kids Providers May 17, 2017 Authorization Extension for STAR Kids Members The Health and Human Services Commission expects managed care organizations to extend long term services and supports (such as Personal Care Services, Community First Choice, and Private Duty Nursing) authorizations for services until completion of the STAR Kids Screening and Assessment Instrument (SAI), but no longer than July 1, 2017. In order to receive payment for these services, you must have authorization from Texas Children’s Health Plan, and the SAI must be completed by...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsAuthorizations, provider alert, SAI, Screening and Assessment Instrument0 CommentsRead more...

02MayMay 2, 2017

Join Us For a Member-Provider Collaborative on Interconception Care

This is a chance to interact with members outside the office in a relaxed setting. What: Member-Provider Collaborative Event On Interconception Care When: Thursday, June 8, 201, 12 p.m. to 2 p.m. Where: The Center for Children and Women-Southwest, 9700 Bissonnet, Houston, TX 77036 RSVP by May 26 to Diane Nunez Email: Diane.nunez@tchp.us Phone: 832-828-1430 Lunch will be served!

By Texas Children's Health PlanEvents, OB/GYNsCollaborative, Interconception Care0 CommentsRead more...

01MayMay 1, 2017

Need Help Navigating Pharmacy Prior Authorizations?

Pharmacy Prior Authorizations (PAs) can be a difficult administrative burden for providers and staff, however, they help ensure patients are receiving the most evidence-based, cost-effective medications. The Vendor Drug Program (VDP) is the state resource for the Texas Medicaid formulary and Preferred Drug List (PDL). VDP has provided a very helpful guide to managing pharmacy benefits for your patients. You can access this resource here: http://casestudies.txhealthsteps.com/stepsQuickCourses/prescribers/ This Quick Course reviews the following: Searching Formulary for prescription and OTC drugs Checking the Preferred Drug List...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, SpecialistsPAs, PDL, Pharmacy, Preferred Drug List, Prior Authorizations, Texas Medicaid Formulary, Texas Vendor Drug Program, VDP0 CommentsRead more...

01MayMay 1, 2017

Provider Alert! Screening for Maternal Depression – Essential to Child Well-Being

Effective January 1, 2017, Texas Children’s Health Plan will reimburse providers for maternal depression screening conducted at a well-child visit. Postpartum depression screening utilizing the Edinburgh Postnatal Depression Scale may be reimbursed up to 2 times per member ages 0-6 months, using CPT code 96161. Code 96161 is used to report the use of a standardized instrument to screen for health risks in the caregiver for the benefit of the patient. The reimbursement for this code will be based on...

By Texas Children's Health PlanOB/GYNs, Provider Alert, SpecialistsDepression, Fax Blast, maternal, OB, OBGYN, Obstetrics, Postpartum, provider alert, screening0 CommentsRead more...