ALERT: Stay healthy this cold and flu season! Learn more
ALERTA: ¡Mantente sano durante esta temporada de influenza y resfriados! Más información
Last Name | First Name | Individual NPI API | Program | Provider Specialty | Termination Effective Date |
Chopra | Atul | 1457672826 | STARKids STAR CHIP | Internal Medicine | 4/1/2020 |
Bennett | J. | 1699741520 | STARKids STAR CHIP | Orthopedic Surgery | 3/30/2020 |
APPLE Homecare Medical Supply | - | 1649259797 | STARKids STAR CHIP | DME/Medical Supplier | 9/1/2020 |
Through the date of termination | Continuity of care period beginning on the effective date of termination for members of special circumstance | ||
Provider remains in network for all members. | For a member who at the time of termination is past the 24th week of pregnancy, the continuity of care period is the effective date of termination – delivery of a child and 6 weeks post-partum care. | For a member who at the time of termination has been diagnosed with a terminal illness, the continuity of care period is the effective date of termination – (not to exceed) 9 months post termination. | For “all other” members, the continuity of care period is the effective date of termination – (not to exceed) 90 days post termination. |
TCHP Care Coordination teams are actively assisting members who wish to transition providers and, as of the termination effective date, will assist with transitioning to in-network providers. Members and Providers can reach TCHP Care Coordination at 1-800-659-5764. | TCHP will review cases and continuation of authorization requests to use the provider only in cases where there is an existing member provider relationship. TCHP will take into consideration the needs of the member related to their care and safety. | TCHP will review cases and continuation of authorization requests to use the provider only in cases where there is an existing member provider relationship. TCHP will take into consideration the needs of the member related to their care and safety. | TCHP will review cases and continuation of authorization requests to use the provider only in cases where there is an existing member provider relationship. TCHP will take into consideration the needs of the member related to their care and safety. |
Providers should expect to receive new agency requests for orders/signature. | TCHP will support the existing service plan and authorized services during the continuity of care period for which treatment may be continued for a period that includes delivery of the child, immediate postpartum care, and the follow-up check-up within the first six (6) weeks of delivery. | If TCHP determines the member meets continuity of care criteria for members with a special circumstance, TCHP will follow its continuity of care processes. In the case of a member who at the time of termination has been diagnosed with a terminal illness, treatment may be continued for 9 months after the effective date of termination. | If TCHP determines the member meets continuity of care criteria for members with a special circumstance, TCHP will follow its continuity of care processes. In the case of “all other” members, treatment may be continued for 90 days after the effective date of termination. |