Our Healthy Rewards Program is getting an update in September! For a sneak peek of all the changes - including new rewards and ways to redeem them - please click here.
¡Nuestro Programa Healthy Rewards tendrá su actualización en septiembre! Para ver un adelanto de todos los cambios, incluyendo nuevas recompensas y formas de canjearlas, haz clic aquí.
Subject: Prior Authorization Guideline updates for Private Duty Nursing (PDN)
Attention: All ProvidersEffective Date: March 1, 2021Providers 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: TCHP would like to inform you of recent updates to the prior authorization requirements and the effective dates. Updates include the following:
Private Duty Nursing, effective March 1, 2021:
Nursing notes, ventilator logs (if applicable), suction logs (if applicable), and seizure logs (if applicable) are no longer required. If not provided, these documents may be requested by TCHP if in the judgement of TCHP, these additional documents are required to adequately assess medical necessity for the requested private duty nursing services.
The request can now be submitted within 30 days of end date of the current authorization.
Effective March 1, 2021, the member needs a treating provider visit at least every year (or every 365 days). This requirement is waived during the COVID disaster declaration period.
