Aside – The Checkup

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...

23DecDecember 23, 2015

Vaccines and Pregnancy

By Dr. Lisa Hollier, MD MPH Chief Medical Officer Texas Children’s Health Plan Professor, Maternal-Fetal Medicine Director, Health Policy Division, Baylor College of Medicine Pregnant women, along with their fetuses, are particularly vulnerable to vaccine-preventable disease-related complications. The Centers for Disease Control and Prevention (CDC) have made recommendations for adult vaccines and there are two that are directly recommended for administration during pregnancy, four are recommended in pregnancy based on additional risk factors, and two are specifically recommended during the postpartum period (see table)....

By Texas Children's Health PlanOB/GYNsfetal, GBS, group b, gynecologist, gynecology, immunization, influenza, maternal, OB, Obstetrics, pregnancy, RSV, tdap, vaccination, vaccines0 CommentsRead more...

01SepSeptember 1, 2015

Provider Alert! Preventing Pre-Term Pregnancies

To: All Providers Subject: Effective September 1, 2015 all Progesterone therapy will require a pre-authorization from Texas Children’s Health Plan. Claims billed using the branded Makena will no longer require a U1 modifier. Pre-authorized use of Makena (hydroxyprogesterone caproate injection) will need to be submitted as J1725 with the appropriate NDC information as required on all claims. Claims billed using the compounded 17-P therapy will now require the U1 modifier. Pre-authorized use of 17-P will need to be submitted as J1725 with the...

By Texas Children's Health PlanOB/GYNs, Provider Alertclaims, pre-authorization, pre-term, pregnancy, pregnant, progesterone, provider alert, providers0 CommentsRead more...