Update: System Configuration Resolution Complete for MDCP Providers

Date: December 22, 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: The issue that we reported to providers last week regarding the new STAR Kids billing matrix effective December 1, 2022 has been corrected. Our system has been updated and we are beginning to reprocess all impacted claims.  

How this impacts providers: Impacted claims are expected to be reprocessed by December 30, 2022. Any claims that have not yet been paid will be processed accurately with the corrected system configuration. As a reminder, 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 identified that claims billed using the U6 modifier were erroneously denying.

Previous communication on this topic: http://www.thecheckup.org/2022/12/16/provider-alert-system-configuration-resolution-in-progress-for-mdcp-providers/

Next steps for providers: There is no action required from providers. 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