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For Providers

As a Texas Children’s Health Plan provider, we value your role in providing quality health care to our members, your patients. Our role as a health plan is to provide you with the tools and resources you need to be successful as efficiently and productively as possible. Texas Children’s Health Plan offers solutions and new technologies that save you time so that you can better serve your patients.

We will keep you updated as new technologies become available. Check our Provider Resources page periodically to stay up-to-date on the latest resources available to you. To learn more, call our provider relations department at 832-828-1008 or toll-free at 1-800-731-8527.

Our website for providers is designed as a tool to help you. You can find an array of resources such as:

Provider Manuals

Helpful links

Member Rights and Responsibilities

Clinical and Administrative Advisory Committee

The Clinical and Administrative Advisory Committees will provide recommendations and assistance to Texas Children’s in the following areas:

  • Development, review and revision of clinical practice guidelines;
  • Review of general clinical practice patterns and assessment of Provider compliance with clinical guidelines;
  • Development of Quality Improvement strategies and studies in coordination with Texas Children’s, HHSC, and the EQRO;
  • Strategies and recommendations for improving Health Plan administrative procedures;
  • Recommendations on how to improve care based on Member feedback and their personal experiences serving our Members; and
  • Opportunities for connecting network Providers and MCO clinical experts for purposes of peer support and sharing best practices.