Tag - claims

Provider Alert!
23Mar

Provider Alert! UPDATE: Recent Claim Denials Issued in Error are now Corrected

Date: March 23, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that we have corrected the internal system error that was previously reported. The error impacted claims processing beginning February 27- March 7, 2023. All impacted claims from this time span have been reprocessed. The erroneous EOP message related to these claims was, “This Provider was not certified/eligible to be paid for this procedure/service on this date of service.” Claims impact report: Your assigned...

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Provider Alert!
10Mar

Provider Alert! Recent Claim Denials Issued in Error are now Being Corrected

Date: March 10, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) is currently addressing recent claim denials that originated from an internal system error. How this impacts providers: No action is required by Providers. TCHP is working diligently to have the system corrected and will reprocess all impacted claims that denied in error by March 24, 2023. The EOP Message for impacted claims: This Provider was not certified/eligible to be paid for this procedure/service on this date of service. Next...

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Provider Alert!
08Mar

Provider Alert! Claims Editing System Reminder

Date: March 8, 2023 Attention: All Providers Call to action: As a reminder, providers are required to bill following the guidance of the CMS and Texas Health and Human Services guidelines. All providers should stay current with these guidelines. Medicaid National Correct Coding Initiative (NCCI) edits may be found at: https://www.medicaid.gov/medicaid/program-integrity/ncci/edit-files/index.html Next steps for providers: Providers should share this communication with their billing staff and confirm that their claims processing systems are configured correctly according to the guidelines provided in the links above. If...

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Provider Alert!
25Jan

Provider Alert! Claims submitted prior to August 1, 2022 Viewable on Texas Children’s Link

Date: January 24, 2023 Attention: All Providers Date claims are available: January 26, 2023 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: We previously communicated to you that claims with a submission date prior to August 1, 2022 were not available to you in Texas Children’s...

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Provider Alert!
06Dec

Provider Alert! Telemedicine/Telehealth claims guidance

Date: November 30, 2022 Attention: All Providers Effective Date: November 21, 2022 Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission.The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March 31, 2022 as announced by the Health...

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Provider Alert!
10Nov

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...

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Provider Alert!
03Oct

Provider Alert! Telemedicine/Telehealth claims guidance

Date: October 3, 2022 Attention: All Providers Effective Date: September 26, 2022 Federally Qualified Health Centers (FQHC) reimbursement for Telemedicine (Physician Delivered) and Telehealth (Non-Physician Delivered) Services as a distant site provider as permanent policy change (per S.B. 670, Texas Legislature, Regular session 2019) ended November 30, 2020 as announced by the Health and Human Services Commission. The content in this message on Rural Health Clinics as telehealth and telemedicine sites will remain in effect through March 31, 2022 as announced by the Health...

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Provider Alert!
16Aug

Provider Alert! Updated Rendering Provider Edit Requirements

Date: August 12, 2022 Attention: All Providers Effective Dates: June 21, 2022 for rendering edit requirements overall September 6, 2022 for new exemptions 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 providers of new billing requirements for the...

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10May

Provider Alert! Updated Age Range for COVID-19 Vaccine Administration Procedure Code M0201

Date: May 4, 2022 Attention: All Providers Effective date: Dates of service on or after October 29, 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. TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for...

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Provider Alert!
22Apr

Provider Alert! Provider Portal Provides Instant Access to Claims and Member Information

Date: April 22, 2022  Attention: All Providers 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 not required to appeal claims unless denied...

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