Our Healthy Rewards Program is getting an update in September! For a sneak peek of all the changes - including new rewards and ways to redeem them - please click here.
¡Nuestro Programa Healthy Rewards tendrá su actualización en septiembre! Para ver un adelanto de todos los cambios, incluyendo nuevas recompensas y formas de canjearlas, haz clic aquí.
New Prior Authorization Fax Line for Medical Inpatient Admissions and Discharge Notifications Authorization Reminders
Date: July 27, 2022 Attention: All Providers Effective date: August 1, 2022Providers 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: TCHP would like to inform you of a recent update to the prior authorization fax lines. New lines will be added for notification for medical inpatient admissions and hospital discharges.
New fax lines effective August 1, 2022
Medical Inpatient Admissions and Discharge Notifications
Toll-Free 844-663-7071 or 832-825-8462
How this impacts providers:
Providers should send medical inpatient admissions and discharge notifications to the new fax line starting 8/1/2022.
Note: TCHP will process admission notifications and discharges that are routed in error to the medical services fax line.
A reminder about the other fax lines:
Medical Services Fax Line - 832-825-8760 or Toll-Free 1-844-473-6860
Behavioral Health Services Fax Line - 832-825-8767 or Toll-Free 1-844-291-7505
LTSS and Private Duty Nursing Fax Line - 346-232-4757 or Toll-Free 1-844-248-1567
Prior Authorization Determinations
The Utilization Management department processes service requests in accordance with the clinical immediacy of the requested services.
Authorization | Turnaround Time
Routine | Within 3 business days after receipt of request
Urgent | Within 1 business day after receipt of request
Inpatient | Within 1 business day after receipt of request
Life-threatening conditions | within one hourPost hospital discharge services | within one business day
TCHP does not require prior authorization for Emergency Medical Conditions or Emergency Behavioral Health Conditions.
Next steps for providers: Providers should share this communication with their staff.
Resources:
Prior authorization formTCHP prior authorization information
Provider alerts related to the authorization information mentioned above:
http://www.thecheckup.org/2020/06/10/provider-alert-update-updates-to-prior-authorization-requirements/If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers
