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.
How do you as a provider with Texas Children’s Health Plan play a role?
In 2015 Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines.
Provider Type
Level/Type of Care
Appointment Accessibility Standards
OB/GYN
Low Risk Pregnancies
Provided within 14 calendar days
High Risk Pregnancies
Offered within 5 calendar days
New Members in the Third Trimester
Offered within 5 days
Primary Care
Urgent care
Within 24 hours
Emergency Care visit
Immediately or refer to ER
Routine primary care
Within 14 days
Adult preventive appointment
Within 90 calendar days
Initial prenatal care (except for high risk pregnancies)
Within 14 calendar days (high risk pregnancies within 5 calendar days)
Texas Children’s Health Plan periodically surveys each participating provider to ensure that your patients are able to access medical care within our provider network.
If you any questions regarding the guidelines and/or your ability to meet these standards, please contact your Provider Relations Manager at 832-832-1008.
