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Becoming a Participating Provider

How to join Texas Children's Health Plan Provider Network

Thank you for your interest in joining Texas Children’s Health Plan network of providers.  Interested providers will complete the following steps for consideration to become a participating provider:

  1. Completion of the Letter of Interest (LOI) Questionnaire

    • Providers must submit a completed LOI Questionnaire along with a W9 Form to the Texas Children’s Health Plan Network Management Department for consideration.Both documents can be submitted either by fax or email as indicated on the LOI Questionnaire Form. Incomplete LOI Questionnaires and/or missing W9 forms will not be considered.

    • The Texas Children’s Health Plan Network Management Department will review to ensure the following criteria are met:

      • Provider is a Texas Medicaid Provider, as applicable

      • Provides services in one of the Texas Children’s Health Plan service areas

      • Has admitting privileges at a Texas Children’s Health Plan participating hospital, as applicable

      • Services provided is a network need for Texas Children’s Health Plan

    • After review and consideration, Texas Children’s Health Plan’s Network Management Department will notify provider of acceptance or denial of LOI. If accepted, Provider will begin the credentialing and contracting process.

       

  2.  The Credentialing & Contracting Process

    • Within five (5) business days, prospective providers will receive an email from Texas Children’s Health Plan, generated through AppCentral, requesting for the completion of the appropriate credentialing application. Prospective providerswill also receive 2 copies of the applicable provider services agreement for review and signature.

    • Once all completed documents are returned (application and signed contracts), Texas Children’s Health Plan will complete the credentialing process within ninety (90) days.

    • Upon successful completion of the credentialing process, Texas Children’s Health Plan’sP Network Management Department will notify the provider of the following:

      • Letter of network participation acceptance with the provider’s effective date

      • Counter-signed provider services agreement

         

  3. New Provider Orientation

    • The assigned Provider Relations Manager will contact new providers to schedule an in-service for your office regarding Texas Children’s Health Plan’s policies and procedures.

 

Joining an Existing Contracted Medical Group? Expedited Credentialing May Apply!

To learn more about the expedited credentialing criteria and instructions, please work with your group’s appropriate designee to access the Texas Children’s Health Plan Provider Portal.

Texas Children’s Health Plan Network Management Department

Phone: 832-828-1063      Fax: 832-825-9360     Email: tchpnetworkmanagemen@tchp.us

Texas Children's Health Plan operates in the following areas:

Areas of Operation
Open Map

For CHIP and STAR: Austin, Brazoria, Fort Bend, Galveston, Harris, Matagorda, Montgomery, Washtingon, Waller, Wharton, Chambers, Hardin, Jasper, Jefferson, Liberty, Newton, Orange, Polk, San Jacinto, Tyler and Walker counties.

For STAR Kids: Anderson, Angelina, Austin, Bowie, Brazoria, Cass, Chambers, Cherokee, Cooke, Delta, Fannin, Fort Bend, Franklin, Galveston, Grayson, Gregg, Hardin, Harris, Harrison, Henderson, Hopkins, Houston, Jasper, Jefferson, Lamar, Liberty, Marion, Matagorda, Montague, Montgomery, Morris, Nacogdoches, Newton, Orange, Panola, Polk, Rains, Red River, Rusk, Sabine, San Augustine, San Jacinto, Shelby, Smith, Titus, Trinity, Tyler, Upshur, Van Zandt, Walker, Waller, Washington, Wharton, and Wood counties.