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Requested Agenda Items
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Description
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Assigned to
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15. 4.
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Update on Claims Alignment Policy for MCOs and Fee-for-Service
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Will be added to the next meeting agenda. JR to provide examples no later than April 3rd.
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TAHCH
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16.
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STAR Kids therapy services Delivered at Private Schools during School Hours Policy Clarification
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Will be added to the next meeting agenda. JR to provide examples no later than April 3rd.
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TAHCH
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17.
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Loss of paperwork
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Add to next agenda - Providers are experiencing paperwork being lost during the transition of when a member is discharged from hospital to home. Providers should continue to send to health plans.
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n/a
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18.
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Therapy access
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Increase in partial and full denials
Difficulties discussing concerns with authorization teams because certain MCOs do not allow for reconsideration and will only allow you to appeal
Concerns with the methods used to issue denials.
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n/a
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19.
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MCO employees showing up at children's private physician's appointments
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Additional information requested by HHSC on March 12, 2018. Once additional information is received, this item will be added to the family/member agenda.
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PTFK
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20.
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New therapy forms being required by Optum. Additional PCP appointments required for "therapy screening"
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Additional information requested by HHSC on March 12, 2018. Once additional information is received, this item will be added to the family/member agenda.
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PTFK
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Hearing screening requirement causing access to care issues
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Additional information requested by HHSC on March 12, 2018. Once additional information is received, this item will be added to the family/member agenda.
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PTFK
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