Uncategorized – Page 3

10JunJune 10, 2020

Provider Alert! Continuing Medical Education/Ethics: Neonatal Abstinence Syndrome Awareness Month resources and events online

Attention: All Obstetric Care Providers Effective Date: June 4, 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: In recognition of Neonatal Abstinence Syndrome (NAS) Awareness Month for the month of June, Texas Children’s Health plan (TCHP) would like to inform you of resources and...

By tcphOB/GYNs, Office Managers, Provider Alert, UncategorizedOB / GYN, Obstetrics0 CommentsRead more...

21AprApril 21, 2020

Provider Alert! Synagis (palivizumab) removed from Texas Medicaid formulary

Attention: All Providers and Pharmacies Effective Date: April 14, 2020 Call to action: The 2019-2020 respiratory syncytial virus (RSV) season ended April 14 for all counties in Texas. Synagis (palivizumab) has been removed from the Texas Medicaid formulary as of April 14. How this impacts providers: Synagis is unproven for prophylaxis outside of the RSV season. Providers wishing to prescribe Synagis during this time must submit a medical necessity request. Next steps for providers: Providers should continue to follow American Academy of Pediatrics (AAP)...

By tcphOB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, UncategorizedPharmacy0 CommentsRead more...

14JulJuly 14, 2019

HEDIS Spotlight

HEDIS® (Healthcare Effectiveness Data and Information Set) is a widely used set of performance measures that ensures our members are getting the best health care possible. It is extremely important that our providers understand HEDIS® specifications and guidelines. This section highlights different HEDIS metrics in addition to providing descriptions of the measures, correct billing codes to support services rendered, and tips to direct you to corresponding resources and tools. MEASURE: FOLLOW-UP AFTER HOSPITALIZATION FOR MENTAL ILLNESS MEASURE DESCRIPTION: Members 6 years of...

By Texas Children's Health PlanUncategorizedHEDIS, mental health0 CommentsRead more...

03MayMay 3, 2019

May is Mental Health Awareness Month

May is Mental Health Awareness Month Year after year, more and more Americans face the reality of living with a mental illness. Despite their age, many young children show early signs of mental illness. These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors. “Half of all mental health disorders show first signs before a person turns 14 years old, and three quarters of mental health disorders begin before...

By Texas Children's Health PlanOB/GYNs, Office Managers, Primary Care Providers, Specialists, UncategorizedBehavioral Health, mental health, Mental Illness, Provider Resources, Toolkit0 CommentsRead more...

19FebFebruary 19, 2019

OB Provider Incentive Program (updated Jan. 2018)

Texas Children’s Health Plan offers an OB Provider Incentive Program to reward your OB provider group for providing quality care to our members during their pregnancy, from early prenatal care to delivery and timely postpartum care. More Information

By Texas Children's Health PlanOB/GYNs, Office Managers, UncategorizedOB Provider Incentives0 CommentsRead more...

07MarMarch 7, 2018

Be a HEDIS HERO for Childhood Wellness

The National Committee for Quality Assurance (NCQA) is a non-profit organization that measures the quality of healthcare across large populations. NCQA does this through its Health Effectiveness and Data Set, also known as HEDIS. HEDIS measures are a set of evidence based standards that Texas Children’s Health Plan is committed to improving upon in order to provide the best care for our members. Making changes across your patient population is easier than you think! In fact, you can become a HEDIS...

By Texas Children's Health PlanUncategorizedAdolescents, Children, HEDIS, NCQA, Nutrition, Weight Counseling, Wellness0 CommentsRead more...

22AugAugust 22, 2017

Provider Alert! Financial Management Service Agency (FMSA)

Subject: Financial Management Service Agency(FMSA) Registration is now open for the Annual Financial Management Service Agency (FMSA) training scheduled for September 19, 2017, 8:30am-5:00pm. This training is mandatory for FMSAs per contracting requirements in Texas Administrative Code, Rules 41.301 and 49.302. In order to comply with this requirement. This required training is now offered in two formats: the FMSA may choose to either attend in-person or by webinar. The in-person training will be at the Winters building located at 701 W. 51st St., Austin, Texas 78751,...

By Texas Children's Health PlanProvider Alert, UncategorizedFMSA, provider alert0 CommentsRead more...

01NovNovember 1, 2016

Texas Children’s Health Plan CMOs introduces STAR Kids

Over the past year and a half, the Texas Children’s Health Plan has been preparing for STAR Kids. This program will offer families with medically complex children the advantage of increased care coordination as part of Medicaid Managed Care. Some of the incredible numbers: 250+ new care coordinators hired and trained by Texas Children’s Health Plan 2,000 new providers added to our network 30,000 new members expected STAR Kids will offer providers additional support and help to reduce the many hassles we run into...

By Texas Children's Health PlanUncategorizedManaged Care, medicaid, STAR Kids0 CommentsRead more...

24OctOctober 24, 2016

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...

By Texas Children's Health PlanOB/GYNs, Uncategorizedconsent form, DFPP, DSHS, EPHC, family planning, HTW, OB, sterilization, Title XIX0 CommentsRead more...