Tag - coverage

Provider Alert!
01Dec

Provider Alert! Coverage of Elevidys Begins January 2024 

Date: November 30, 2023  Attention: All Providers  Prior authorization effective date: February 1, 2024 Call to action: The purpose of this communication is to inform providers that on January. 1, 2024, Elevidys will become a benefit of Medicaid and CHIP. Health and Human Services commission (HHSC) will require prior authorization for Elevidys (procedure code J1413) for Medicaid and CHIP, effective February 1, 2024. Elevidys is an adeno-associated virus vector-based gene therapy indicated for the treatment of ambulatory pediatric clients ages 4 through 5 years...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
29Aug

Provider Alert! Medicaid Re-enrollment: Patients May Risk Losing Their Medicaid Plan!

Date: August 28, 2023 Attention: All Providers Call to action: Texas Children’s Health Plan (TCHP) would like to thank you for supporting your patients with maintaining coverage during the Medicaid re-enrollment currently underway. Background information: As you may know, Medicaid coverage rules have changed, and some Medicaid recipients need to go through the renewal process to determine their eligibility for coverage. This is the result of the Consolidated Appropriations Act, 2023 (CAA, 2023) that was enacted on December 29, 2022. The CAA ended the...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , 0 CommentsRead more...
Provider Alert!
14Jun

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...

By Facilities, HHSC, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , 0 CommentsRead more...
30Jun

Provider Alert! Provider Information – Patient’s Medicaid Coverage may be Impacted by the end of the COVID-19 Public Health Emergency

Date: June 23, 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. Call to action: Texas Children’s Health Plan (TCHP) would like to provide you an update in regards to member’s Medicaid coverage and the upcoming conclusion of the public health emergency (PHE). The federal...

By OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , 0 CommentsRead more...
Provider Alert!
29Mar

Provider Alert! Guidance on Medicaid Coverage of Generators

Date: March 29, 2022 Attention: All Providers Effective date: June 27, 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 not required...

By Facilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, Specialists, , , , , 0 CommentsRead more...
15Nov

Provider Alert! Pfizer COVID-19 Vaccine Coverage Update

Date: November 15, 2021 Attention: All Pediatric and Family Medicine Providers Effective Date: 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. Call to action: New information for November 9, 2021: the FDA issued a new emergency use authorization (EUA) for the use of the Pfizer-BioNTech COVID-19...

By Primary Care Providers, Provider Alert, , , , 0 CommentsRead more...