Primary Care Providers

Articles with relevant information for Primary Care Providers (PCP).
18Mar

Provider Alert! Update – Telemedicine & Telehealth Services and COVID-19

Attention: All Providers Effective Date: March 17, 2020 Texas Children’s Health Plan supports the delivery of telemedicine and telehealth services to its members. As part of our COVID-19 Emergency Response, Texas Children’s Health Plan will add coverage of telemedicine services that are provided through only synchronous audio interactions (audio-only telephone consultation). How this impacts providers: Telemedicine services should be provided in compliance with standards established by the respective licensing or certifying board of the professional providing the services. While telemedicine services do not require...

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18Mar

Provider Alert! Reporting Provider Office Closures and Changes due to COVID-19

Attention: All Providers Effective March 17, 2020 Reporting Provider Office Closures and Changes due to COVID-19 The severity of the Coronavirus disease 2019 (COVID-19) may have affected your ability to operate during normal business hours. If your office has made any changes to the regular business operations or has closed entirely and unable to provide services to our members at this time, please complete an online questionnaire on our main website, https://www.texaschildrenshealthplan.org/for-providers. Be sure to include any changes to your office status and the...

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Provider Alert!
02Mar

Provider Alert! Additional development screenings and autism screenings now allowable and payable beyond the standard screenings

Effective Date: June 3, 2020 Attention: Primary Care Providers Call to action: In addition to the required screenings, TCHP is allowing for a total of 12 developmental screenings up to age 6 during a Texas Health Steps Checkup within the following ages: 8.1-  2 screenings At ages 0-11 months 8.2- 3 screenings At age 12-23 months 8.3- 2 screenings At ages 12-23 months 8.4- 2 screenings At ages 24-35 months 8.5- 1 screening At 3 years of age 8.6- 1 screening At 5 years of age 8.7-1 screening At 6 years of age   If a developmental or...

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Provider Alert!
02Mar

Provider Alert! Prosthetics Codes Update

Effective Date: June 3, 2020 Attention: Prosthetics, DME providers, orthopedists, podiatrists, PCPs Call to action: Texas Children’s Health Plan will now configure the prosthetics procedures codes to require prior authorization according to the Texas Medicaid Provider Procedures Manual (TMPPM).  Currently, the only procedure codes on the prior authorization list are related to Breast Reconstruction. How this impacts providers: Provider offices should utilize the Standard Prior Authorization Form for prosthetics that require a prior authorization: https://www.texaschildrenshealthplan.org/for-providers/provider-resources/prior-authorization-information Next steps for providers: Providers should reference the prosthetic procedure...

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07Feb

American Heart Month

Heart disease is a catchall phrase for a variety of conditions that affect the heart’s structure and function1. This month we’re spotlighting American Heart Month in an effort to increase awareness about heart disease, as well as remind Texas Children’s Health Plan providers to encourage their patients to adopt healthy lifestyles. It’s important to inform your patients that heart disease can be prevented by incorporating healthy choices and managing health conditions. Share the following information with your patients as part of...

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28Jan

Provider Alert! Novel Coronavirus Infection – 5 Confirmed US Cases

Attention: All providers Effective Date: January 27, 2020   TCHP wants to help keep you up-to-date on developing issues.  Because updates are coming so frequently about the new coronavirus, please look for our posts on TheCheckup.org where you’ll find the latest information.  Also check with your institutional leaders to see if they have developed specific protocols for infection control.  A new coronavirus (2019-nCoV) was recently detected in Wuhan City, China and is causing an outbreak of respiratory illness. The 2019-nCoV outbreak began in December...

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06Jan

Zantac/ranitidine drug recalls due to NDMA impurity

Multiple drug manufacturers have issued voluntary drug recalls for several Zantac drug products and its generic, ranitidine. Ranitidine is a histamine-2 receptor antagonist used to treat heartburn and related conditions. Potentially impacted customers are being notified with a recommendation to stop taking the medication and to discuss alternative therapies with their provider. The recalls are due to discovery of an impurity (N-nitrosodimethylamine [NDMA]) in the finished product. NDMA is classified as a probable human carcinogen that may be found in certain...

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03Dec

The Flu and Antiviral Medications

Flu season is here and Texas Children’s Health Plan hopes everyone has received their flu vaccine. If you haven’t gotten your flu vaccine, it’s not too late! When you diagnose a patient with the flu, it’s important to understand when you can treat with antivirals, as well as which antiviral medications are approved and recommended for treatment each flu season. Antiviral medications work best if started within two days of getting sick with the flu. There are currently three antiviral medications that...

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Provider Alert!
26Nov

Provider Alert! Texas Department of State Health Services (DSHS) Laboratory Web Portal

On October 25th, it was reported that the laboratory web portal application for public health experienced unexpected technical difficulties. It is currently not available and as a result, the provider report cards are unavailable at this time. While DSHS Laboratory is actively working on a solution, there is not a date for when the matter will be resolved. How this impacts providers: Texas Health Step Providers that normally receive results via the Laboratory Web Portal will have the reports mailed to...

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Provider Alert!
06Nov

Provider Alert! Acute Therapy Services

Acute Therapy Services Requests for acute occupational speech and physical therapy services will require documentation from the prescribing provider that a visit for the acute injury or acute exacerbation of the medical condition requiring therapy has occurred within the last 90 days. Acute speech therapy authorization will not require evidence of current Texas Health Steps well checkup for therapy treatment requests of 60 days or less. Therapy services for greater than 60 days will require evidence that the member is current in their...

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