Tag - billing

Provider Alert!

Provider Alert! Update to Therapeutic Optometry Billing Services for CPT Code 65778

Date: January 12, 2023 Attention: Therapeutic Optometrists Effective: April 11, 2024 Call to action: Effective for dates of service on or after April 11, 2024, therapeutic optometrists are to bill with taxonomy code 152WV0400X (optometry vision therapy) when billing for placement of amniotic membrane on the ocular surface; without sutures, CPT code 65778. Next steps for providers: Providers should verify they are enrolled through Texas Medicaid & Healthcare Partnership (TMHP) under the therapeutic optometry taxonomy with code 152WV0400X in order for claims to process...

Provider Alert!

Provider Alert! Member Eligibility Verification Methods and Information on Medicaid Billing!

Date: June 14, 2023 Attention: All Providers Member eligibility information: Texas Children’s Health Plan (TCHP) would like to remind providers that the Medicaid and/or CHIP coverage rules changed, beginning April 1, 2023. This means that some of our members will need to go through the process to determine their eligibility for coverage. Our members will be required to renew their Medicaid and/or CHIP coverage or risk losing their plan and access to healthcare. TCHP has actively communicated with members about this change...

Provider Alert!

Provider Alert! Reminder of Updated Rendering Provider Edit Requirements

Date: November 10, 2022 Attention: All Providers Effective Dates: June 21, 2022 for rendering edit requirements Further clarification provided: November 10, 2022 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 the nature of the COVID-19 Event. Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers of billing requirements for the...

Provider Alert!

Provider Alert! Changes to the STAR Kids LTSS Billing Matrix

Date: August 5, 2022                     Attention: STAR Kids Providers Effective date: December 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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: UPDATE July 14, 2022: On June 1, 2022, the Health and Human Services Commission (HHSC) comprehensively revised the Long-Term Services and Supports (LTSS)...

Provider Alert!

Provider Alert! Clarification for the STAR Kids LTSS Billing Matrix Revisions

Date: June 6, 2022                         Attention: STAR Kids Providers Effective date: December 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are...

Provider Alert!

Provider Alert! Clarification for the STAR Kids LTSS Billing Matrix Revisions

Date: June 6, 2022                        Attention: STAR Kids Providers Effective date: December 1, 2022 Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are...

Provider Alert! Update to COVID-19 Testing Billing, Modifier QW

Date: March 21, 2022 Attention: Primary Care Providers Effective Date: January 3, 2022 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. Regarding system configuration updates, TCHP will apply updates and reprocess impacted claims as soon as possible. However, due to volume, please allow up to sixty (60) business days...

Provider Alert!

Provider Alert! 2022 Healthcare Common Procedure Coding System (HCPCS) Update

Date: February 11, 2022 Attention: All Providers Effective Date: January 1, 2022 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) aligns with the Healthcare Common Procedure Coding System (HCPCS) additions, revisions, and discontinuations that are implemented for claims processing by TMHP...

Provider Alert!

Provider Alert! New Provider Type for Non-Local Mental Health Authority Providers of Mental Health Targeted Case Management/Rehab

Date: October 19, 2021 Attention: Billing Services for Behavioral Health Providers (Non-LMHAs) Subject: New Provider Type for Non-Local Mental Health Authority Providers of Mental Health Targeted Case Management/Rehab Deadline for provider enrollment: November 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...

Provider Alert!

Provider Alert! Reminder of mailing address and procedure for overpayments

Attention: All Providers Effective Date: March 20, 2020 Should a provider receive an overpayment from Texas Children’s Health Plan they should immediately take the following action. A provider has an obligation to notify Texas Children’s Health Plan in writing upon identification of an overpayment, no more than thirty (30) days from the date of discovery. The overpayment can be remediated through refund to Texas Children’s Health Plan, or a provider may request a recoupment from future claim payments.   For refunds: If a provider wishes...