June 2017

Attention All Medicaid Providers – TMHP Enrollment Due by Dec. 31 to Continue Receiving Reimbursements for CHIP Services; CHIP-only Providers Must Designate by July 1, 2017

Providers who currently render services to CHIP members through a MCO must complete enrollment with the Texas Medicaid & Healthcare Partnership (TMHP) by December 31, 2017. Beginning July 1, 2017, providers can designate in their enrollment applications that they intend to serve only CHIP members.

Changes in Prior Authorization Process as of June 1, 2017

A full list of services that eviCore^TM healthcare will provide utilization management pre-service authorization for is available. Find out when you can contact eviCore directly for specialty services preauthorization, how to request an authorization and what to do for urgent requests.

AAPCA Medicaid Benefits Transition to Managed Care

Learn about the transition of Medicaid benefits from Adoption Assistance and Permanency Care Assistance (AAPCA) to managed care starting this fall.

Reminder: Address Changes for Claims, Appeals and Overpayment Recovery Requests

The address for claims and appeals submissions changed on December 31, 2015. The overpayment recovery address changed on June, 1, 2017.

Postpartum Depression (PPD) Toolkit Available

The Texas Health and Human Services has asked Medicaid and CHIP health plans to share the new Texas Clinician’s PPD toolkit with their providers. The toolkit is a resource for screening, diagnosis and treatment of PPD.

Well-child Visits: The First 15 Months of Life, Plus STAR/CHIP Survey

Blue Cross and Blue Shield of Texas (BCBSTX) is focusing on increasing the percentage of members who complete six well-child visits within the first 15 months of life. As a health care provider, it is important to encourage parents to follow the recommended schedule for well-child visits and to fully document the care you provide. Additionally, we’re asking that you fill out a short survey about our shared STAR and CHIP members, which includes questions about pregnant members.

STAR Kids and Texas Health Steps

Learn about the requirements and components of the STAR Kids Medicaid managed care program for disabled children ages 20 and younger.

You are invited to participate in upcoming provider training webinars. Our webinars provide information and resources to fully engage our provider community. The schedule is below, and we ask that you RSVP by the deadline.

Note: If you’re not able to attend any of the trainings below, they are available for completion via Brainshark at your own pace, date and time.