Provider Alerts! Prior Authorization Updates

Date: November 7, 2022 Attention: All Providers               Effective date: September 1, 2022Providers 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 (TCHP) would like to inform providers of updates to the prior authorization lists. How this impacts providers: The updates are as follows:

• Effective August 22, 2022: Targeted Case Management and Mental Health Rehabilitation Services no longer requires prior authorization
• Effective September 1,2022: Case Management for Children and Pregnant Women carve-in requires a prior authorization

Next steps for providers: Providers should become familiar with the prior authorization guidelines and check them regularly for further updates. Click here for Prior Authorization Requirements Links to provider alerts previously posted: Targeted Case Management and Mental Health Rehabilitation Services: http://www.thecheckup.org/2022/08/31/provider-alert-prior-authorization-is-no-longer-required-for-mental-health-targeted-case-management-and-mental-health-rehabilitative-services/ Case Management for Children and Pregnant Women carve-in: http://www.thecheckup.org/2022/10/06/provider-alert-case-management-for-children-and-pregnant-women-cpw-carve-in-4/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.