Tag - CHIP

No-cost sports and school physicals for CHIP and Medicaid patients

It’s back-to-school season, which means your patients will need to complete their annual sports and school physicals. As a value added service through our Healthy Rewards Program, CHIP and STAR patients ages 5 to 19 years and STAR Kids patients under 21 years can receive a no-cost sports and school physical if they have completed a Texas Health Steps or well-child visit within the last 12 months. Providers will be reimbursed for the cost of the sports and school physical. For...

Provider Alert!

Provider Alert! CHIP Member Eligibility Now Available via EDI HIPAA 270/271 Transaction

Attention:  CHIP Providers and Submitters RE: CHIP Member Eligibility Now Available via EDI HIPAA X12 270/271 Transaction Note: This applies only to CHIP providers and submitters. No action is required for Medicaid providers or submitters. Available immediately, CHIP providers and submitters wishing to request and receive CHIP member eligibility using HIPAA X12 270/271 transactions may begin utilizing a new eligibility system. CHIP providers and Electronic Data Interchange (EDI) submitters may begin the Trading Partner Testing process by contacting TMHP at EDI.Eligibility@tmhp.com to receive...

Provider Alert!

Provider Alert! CHIP Co-Payments

Attention: All Texas Children’s Health Plan Providers Subject: CHIP- Co-Payments On Thursday, August 31, 2017, the Centers for Medicare and Medicaid Services (CMS) approved the state's request to waive Children’s Health Insurance Program (CHIP) co-payments for members with a permanent address in one of the Hurricane Harvey Federal Emergency Management Agency (FEMA) declared disaster counties. FEMA-declared disaster counties for Hurricane Harvey may be accessed here: https://www.fema.gov/disaster/4332. Co-payments are waived for services provided August 25, 2017 through November 30, 2017. Therefore, providers must not require or...

Provider Alert!

Provider Alert! Enrollment Information for CHIP Providers

Attention CHIP Providers Enrollment Information Specific to CHIP Providers Federal law and regulation require states to screen and enroll all network providers including Children’s Health Insurance Program (CHIP) providers by December 31, 2017. To meet this requirement and continue receiving reimbursement for services, providers who currently render services to CHIP members through (Texas Children’s Health Plan) must complete enrollment with the Texas Medicaid & Healthcare Partnership (TMHP) by December 31, 2017. While the enrollment process and application are the same for Medicaid and...

Ensure the continuity of care for your teenage patients

During the transition from adolescence into adulthood, usually between the ages of 18 and 19, many Pediatric Primary Care Physicians inform their patients that they will no longer be able to serve as their Physician and ask them to secure a new Physician in an adult practice. After many years of being cared for by one Pediatric Physician, we recognize this can be an emotional time for everyone involved; however, Texas Children’s Health Plan is here to help. At Texas...

Provider Alert! LARC Billing Update

Paragard and Nexplanon have been added to the Long-Acting Reversible Contraceptives (LARC) Buy Back Program. Paragard IUD (manufactured by Teva) and Nexplanon Implant (manufactured by Merck), have been added to the LARC Buy Back program, as the Mirena and Skyla currently are. Mirena and Skyla are currently available from Walgreens Specialty Pharmacy (NOTE: that has not changed from before). The Texas Medicaid/CHIP Vendor Drug Program has verified which pharmacies the Paragard IUD and Nexplanon Implants are available. In the case of Paragard: Biologics, Inc, Specialty...