System Configuration Resolution in Progress for MDCP Providers

Date: December 16, 2022

Attention: MDCP Providers

Providers 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 notify providers of an internal system configuration issue that has been identified regarding the new STAR Kids billing matrix that went live on December 1, 2022. This is a global issue that we have prioritized for expedient review and resolution. We are assessing all impacted providers to fully understand the matter and will remediate globally. Another update will be provided, as soon as available.

How this impacts providers: In accordance with the HHSC new STAR Kids Billing Matrix, which became effective December 1, 2022, modifier U6 was implemented for MDCP member claim information.  TCHP has identified that claims billed using the U6 modifier are currently erroneously denying. We are working diligently to correct this issue. And will then work to pull any impacted claims and adjust for payment, as appropriate.

Next steps for providers: There is no action required from providers at this time. If you have questions, please contact your Provider Relations Liaison or Account Lead. You can also email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers