Dental Varnish Services

Date: October 16, 2019 Attention: Primary Care Providers Subject: Dental Varnish Services Call to action: Texas Children’s Health Plan (TCHP) identified an error in the reimbursement of dental varnish services.  This error may have resulted in non-payment of this service during a medical checkup for TCHP members who are 6 to 35 months of age.  An update to TCHP’s claims payment system is currently in process and all impacted claims will be reviewed and reprocessed for payment within the next 30 days. How this impacts providers:  There is no need for providers to appeal impacted claims due to this error, but providers should ensure claims are billed correctly as outlined in Section 5.3.12.1 Oral Evaluation and Fluoride Varnish (OEFV in the Medical Home) of the October 2019 Texas Medicaid Provider Procedures Manual (TMPPM). Next steps for providers: Please review Texas Medicaid Provider Procedures Manual for assistance with billing for dental varnish services. If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.For access to all provider alerts,log into: www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.