medicaid – Page 6 – The Checkup

15JunJune 15, 2020

Provider Alert! New Federal Enhanced Provider Relief Funds for Medicaid and CHIP Providers

Attention: All Providers Effective Date: June 10, 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: Texas Children’s Health Plan (TCHP) would like to inform you of new federal Enhanced Provider Relief Funds for Medicaid and CHIP providers. Here are the details: Beginning June 10, eligible...

By tcphOB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsCHIP, COVID, COVID-19, medicaid0 CommentsRead more...

07MayMay 7, 2020

Provider Alert! COVID-19 Medicaid Pharmacy Benefit Updated May 4, 2020

Attention: All Providers and Pharmacies Effective Date: May 4, 2020 The Texas Vendor Drug Program (VDP) has implemented several changes in response to COVID-19. This notice contains the latest updates, as well as links to the previously implemented changes. No-auto prior authorization (NAP) designation temporarily lifted: Normally, medications listed as NAP on the drug formulary by VDP require a manual hard stop in the system. Providers must call/fax to complete a prior authorization (PA) rather than allowing automated authorizations by reviewing historical pharmacy...

By Texas Children's Health PlanOB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsCOVID, COVID-19, medicaid, Pharmacy, provider alert, provider alerts, VDP, Vendor Drug Program0 CommentsRead more...

15AugAugust 15, 2019

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...

By Texas Children's Health PlanOB/GYNs, Office Managers, Primary Care Providers, Specialistsback-to-school, CHIP, medicaid, physicals, sports physical, STAR0 CommentsRead more...

13FebFebruary 13, 2017

What is the role of STAR Kids Service Coordinators?

A Service Coordinator is the central contact between Texas Children’s Health Plan and a member’s providers and family members. The purpose of a Service Coordinator is to maximize a Member’s health, wellbeing and independence. The Service Coordinator must work with the Member’s PCP to coordinate all of a member’s health services. The STAR Kids Service Coordinator also engages as an advocate and intervenes on behalf of the member if approved by the member. The Service Coordinator will perform an overall evaluation...

By Texas Children's Health PlanFacilities, OB/GYNs, Office Managers, Primary Care Providers, Provider Alert, SpecialistsAdolescent Transition, Advocacy, medicaid, Service Coordination, Service Coordinators, STAR Kids0 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...

03AprApril 3, 2016

STAR Kids 101: Learn the Basics

What is STAR Kids? STAR Kids will be the first Medicaid managed care program in Texas specifically serving youth and children who get disability-related Medicaid. Texas Children’s Health Plan STAR Kids program will provide services, including long term support services (LTSS), for members ages 20 or younger who either receive Supplemental Security Income (SSI) Medicaid or are enrolled in the Medically Dependent Children Program (MDCP). Children and youth who receive services through other 1915(c) waiver programs will also receive their basic...

By Texas Children's Health PlanSpecialistsCare Coordination, Disability, LTSS, MDCP, medicaid, SSI, STAR, STAR Kids, texas0 CommentsRead more...

17MarMarch 17, 2016

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...

By Texas Children's Health PlanOB/GYNs, Office ManagersCHIP, IUD, LARC, medicaid, Nexplanon, Paragard, reversible contraception, Vendor Drug Program0 CommentsRead more...

21JanJanuary 21, 2016

Provider Alert! Annual Reminder on Copayments and Deductibles

To: All Texas Children’s Health Plan Providers Subject: Annual Reminder on Copayments and Deductibles Texas Children’s Health Plan will pay for a primary insurance deductible with proof of assignment to the deductible on the primary evidence of procedure. Payments will be made up to Medicaid allowable only. Claims for primary insurance copayments should be sent to Texas Medicaid and Healthcare Partnership directly. Texas Children’s Health Plan will not pay CP001 or CP002 on a claim as these are not payable by the managed...

By Texas Children's Health PlanOffice Managers, Provider Alertcopayments, deductibles, insurance, medicaid, provider alert0 CommentsRead more...

23DecDecember 23, 2015

Provider Alert! Long Acting Reversible Contraception (LARC) Billing Changes

To: All Providers and Facilities Subject: Long Acting Reversible Contraception (LARC) Billing Changes Recent changes at Health and Human Services Commission (HHSC) has improved the accessibility of LARC devices for Medicaid members. HHSC is currently working to add ParaGard, Nexplanon and Liletta to the Medicaid Vendor Drug Program formulary. More information on these products and the process to order will be supplied as these are added. Once added, providers may choose to continue to “buy and bill” or they may choose to...

By Texas Children's Health PlanOB/GYNs, Office Managers, Provider Alertbilling, contraception, hhsc, insurance, LARC, medicaid, provider alert, provider relations, reversible contraception0 CommentsRead more...

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