Provider Alert

Articles with information about Provider Alerts.

Provider Alert!
28Jan

Provider Alert! Prior Authorization Criteria for Uplizna

Date: January 19, 2021 Attention: All Providers Effective Date: January 1, 2021 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 inform network providers that the Health and Human Services Commission (HHSC) has added Texas Medicaid and CHIP prior authorization...

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Provider Alert!
28Jan

Provider Alert! Evrsydi available on Medicaid formulary with prior authorization requirements on Feb 1

Date: January 25, 2021 Attention: Neurologists and SMA specialists Effective Date: February 1, 2021 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: Prescribers should be aware that Evrysdi will be available to members through Texas Medicaid pharmacy benefit effective February 1. Access will require meeting clinical prior authorization criteria for Evrysdi (risdiplam).  Evrysdi is indicated for treatment...

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26Jan

Provider Alert! Medicaid, STAR Kids, CHIP, and CHIP Perinatal eligibility during COVID-19

Date: July 23, 2021 Attention: All providers Subject: Medicaid, STAR Kids, CHIP, and CHIP Perinatal eligibility during COVID-19 Effective Date: July 22, 2021 For STAR Kids Age Outs that complete their transitions August 1, 2021. The content in this message on STAR Kids Age-Outs that transitioned on April 1, 2020 will remain in effect through July 31, 2021. Individuals ageing out starting May 1, 2021 are following normal timelines and processes, as announced by the Health and Human Services Commission. TCHP COVID-19 Utilization Management Procedure...

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Provider Alert!
26Jan

Provider Alert! Immobilized Lipase Cartridges to Become a Benefit of Texas Medicaid

Attention: All Providers Effective Date: March 1, 2021 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 network providers that effective for dates of service on or after March 1, 2021, immobilized lipase cartridges (procedure code B4105)...

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Provider Alert!
26Jan

Provider Alert! Guidelines for Opioid Prescribing in Children and Adolescents After Surgery

According to the Centers for Disease Control, 17.3% of those who abuse prescription painkillers are prescribed medication from a physician. Management of post-surgical pain is one of the most common reasons that young adults are prescribed opioids rather than over-the-counter pain medications. The American Pediatric Surgical Association assembled an expert panel of health care professionals caring for children who require surgery; reviewed literature regarding opioid use and risks unique to pediatric populations and developed a broad framework for evidence-based framework...

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Provider Alert!
26Jan

Provider Alert! Annual HEDIS ® Medical Record Review Process to Begin in February

Date: January 26, 2021 Attention: Primary Care Providers Review Period: February through May 2021 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 would like to inform network providers that the HEDIS® medical record data review process will begin in early February 2021 and proceed through...

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Provider Alert!
22Jan

Provider Alert! Obstetric Care Providers and Radiologists

Attention: Obstetric Care Providers and Radiologists     Effective Date: March 1, 2021 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 notify network providers that effective for dates of service on or after March 1, 2021, digital...

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Provider Alert!
19Jan

Provider Alert! Subject: Emergency Extensions for Optometry Provider License Renewals

Attention: Optometrists Effective Date: December 18, 2020 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 network optometrists that due to the ongoing COVID-19 public health emergency, effective December 18, 2020, the Texas Optometry Board has issued an emergency rule extending the...

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Provider Alert!
15Jan

Provider Alert! Online Authorization Platform is Now Operational

Date: January 13, 2021 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) would like to inform providers that utilize our online authorization platform; Health Trio this platform is restored and is now functional and accepting authroizations. How this...

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Provider Alert!
15Jan

Provider Alert! Essential Information for Prior Authorization Submission

Date: January 13, 2021 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) would like to remind network providers of the required information for a prior authorization submission. The Texas Standard Prior Authorization Form* including the following information: Member Name Member...

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