Tag - NPI

Provider Alert!
11May

Provider Alert! Inactive National Provider Identifiers in National Plan and Provider Enumeration System to Trigger Disenrollment Action

Date: May 10, 2023 Attention: All Providers Effective date: April 27, 2023 Call to action: Texas Children’s Health Plan (TCHP) would like to make providers aware that Texas Medicaid and Healthcare Partnership (TMHP) has identified several National Provider Identifiers (NPI) as inactive in the National Plan and Provider Enumeration System (NPPES) and will be taking immediate disenrollment action which will result in a payment denial code (PDC) 64 added on to the provider record in the Master Provider File (MPF). Provider Requirements, verification and...

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Provider Alert!
16Dec

Provider Alert! Correction to Rendering Provider Guidance Previously Provided

Date: December 16, 2022 Attention: All Providers   This communication is an update to the communication providedon November 23, 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: Please note this communication is a correction to the communication provided on November 23,2022. How this impacts providers: TCHP would...

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Provider Alert!
13Jul

Provider Alert! Provider Enrollment and Management System (PEMS) Provider Guidance

Date: July 7, 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...

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Provider Alert!
19Nov

Provider Alert! Texas Medicaid and Healthcare Partnership (TMHP) Provider Enrollment and Management System (PEMS)

Date: November 29, 2021 Attention: All Providers Effective Date: December 13, 2021 for PEMS Webinar date: December 7, 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 Plan would like to remind providers that the Texas Medicaid & Healthcare Partnership’s (TMHP) Provider Enrollment and...

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Provider Alert!
06Apr

Provider Alert! Update: New Edit Implemented by Claims Processor, Change HealthCare

Date: April 5, 2021 Attention: All Providers Effective Date: March 25, 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: This is an update to communication we previously posted: For network providers that have submitted institutional claims, (UB04 837I) from February 16, 2021 through March 25, 2021...

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Provider Alert!
01Sep

Provider Alert! New Claims Requirements Effective September 1, 2018

Date: August 20, 2018 New Claims Requirements Effective September 1, 2018 Attention:  Network Providers   Billing taxonomy Per section 6.2.1 of the TMPPM Billing providers must submit the taxonomy number on all electronic claims with the exception of Medicare primary claims. Electronic claims without a billing taxonomy will be rejected.   Claim Requirement Electronic Claim Billing Provider Taxonomy Code (required on all claims) 2000A, PRV03   Ordering/Referring Provider Requirement For services that require an ordering/referring provider the NPI of the ordering/referring provider must be attested. Billing providers can verify an ordering/ referring...

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