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ALERT! We now encourage our patients to save their spot in line before coming into the clinic.

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ALERTA PARA MIEMBROS EN TYLER, TEXAS: 
Si necesitas ayuda debido a las recientes tormentas, cortes de energía y/o inundaciones, visita findhelp.org. Puedes encontrar recursos gratuitos o de costo reducido incluyendo alimentos, viviendas, atención médica y más. 

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Frequently Asked Questions

View the Becoming a Provider page to review the steps on becoming a provider.

View the CHIP/STAR Provider Manual for information.

Provider manuals can be found on the For Providers page.

You can find training materials on how to use Texas Children’s® Link by logging into the portal and scrolling to the bottom under “Quick Links” called “How-To Videos: Texas Children’s Link for TCHP users”

Additionally, you can find training materials and information on upcoming events on our Provider Training and Events page. For questions, please contact your Provider Relations Liaison or call 832-828-1004 (toll free 1-800-731-8527).

You can find information on prior authorizations on our Prior Authorization Information page.

Please contact us at 1-800-731-8527 (toll free) if you have questions or need assistance with prior authorizations.

Providers may also reach out to their Provider Relations Liaison, contact information is available here.

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
  • TCHP does not require prior authorization for Emergency Medical Conditions or Emergency Behavioral Health Conditions
  • Post hospital discharge services | Within one business day

Read more on the Prior Authorization Information page.

Texas Children’s® Link is our new platform that consolidates communications into one single, robust and powerful system. The new portal is built to enhance collaboration between Texas Children’s® Health Plan staff, members and providers.

As a Texas Children’s Link user, you can:

View Texas Children’s Health Plan member eligibility and benefits – Access members’ coverage information.

Manage referrals, orders and prior authorizations – Submit and review authorizations and notification letters electronically.

Access patient clinical activity provided at Texas Children’s – Eligible provider types will have access to view clinical records for services provided at Texas Children's care locations.

Submit, review and appeal claims – Submit claims and/or claim appeals for our members and check statuses.

Manage your population – Access care management tools, scorecards and analytics that help you coordinate your patient populations' care.

If you have questions regarding account access or training, please contact your Provider Relations Liaison or call us at 832-828-1004 (toll free 1-800-731-8527).

Click here to login to Texas Children’s® Link. If you have questions regarding account access, please contact your Provider Relations Liaison or call us at (832) 828-1004 (toll free 1-800-731-8527).

We’ve put together quick how-to videos which can be accessed by logging into the portal and scrolling to the bottom under “Quick Links” called “How-To Videos: Texas Children’s Link for TCHP users”.

Please contact the Contracting department directly by calling 832-828-1004 (option 6) or by email at tchpnetworkmanagement@texaschildrens.org.

For claims-related questions, contact Customer Service at:

Phone: 832-828-1004
Toll free: 1-800-731-8527
Telephone TouCHPoint: 832-828-1007
Fax: 832-825-8750

Providers can find a Claim Appeal Form and details on how to send it on our Provider Complaints and Appeals page.

Providers can access members’ coverage information on our portal, Texas Children’s® Link.

For additional questions, contact Customer Service at:

Phone: 832-828-1004
Toll free: 1-800-731-8527
Telephone TouCHPoint: 832-828-1007
Fax: 832-825-8750

You can find several resources on behavioral health as well as information listed in the provider manuals on our Provider Resources page.

All address changes must be reported to HHSC. Members can contact HHSC by calling 2-1-1 or by updating their account on YourTexasBenefits.com

It is important to make sure address information is updated in a timely manner to ensure families continue to receive information from Texas Children’s Health Plan and HHSC. If a member has moved to an area that is not covered by Texas Children’s Health Plan they will need to select a new health plan. If a family is unsure if they have moved to an area that is outside of Texas Children’s Health Plan’s service area, we can help them by connecting them to HHSC so the address change can be made. Members will continue to have access to care through Texas Children’s Health Plan until HHSC changes their address.

If a Member needs help, call Member Services toll-free at 1-866-959-2555 (STAR), 1-866-959-6555 (CHIP), or 1-800-659-5764 (STAR Kids).