Infant Formula Recall Retirada del mercado de fórmula infantil

ALERT: ByHeart Recalls Whole Nutrition Infant Formula. Read more

AVISO IMPORTANTE: ByHeart retira del mercado su fórmula infantil Whole Nutrition. Aprender más

Transportation Update Actualización de transporte

Starting December 15, 2025, SafeRide Health will become the new provider for all member rides to doctor appointments and pharmacy visits. After this date, Texas Children’s Health Plan will no longer use MTM for Non Emergency Medical Transportation (NEMT) services.

Learn more here

For other questions, please call Member Services at the number on the back of your member ID card.

A partir del 15 de diciembre de 2025, SafeRide Health será el nuevo proveedor para todos los viajes de los miembros a citas médicas y visitas a la farmacia. Después de esta fecha, Texas Children’s Health Plan ya no usará MTM para los servicios de Transporte Médico No Urgente (NEMT).

Obtenga más información AQUI

Si tiene otras preguntas, llame a Servicios para Miembros al número que aparece en la parte posterior de su tarjeta de identificación del miembro.

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Authorization and Verification Process Updates

Texas Children’s Health Plan has made updates to the authorization process. Individual Member Fax Requests To ensure Health Insurance Portability and Accountability Act (HIPAA) compliance, providers must send one fax request per member with each fax having its own cover sheet. Requests received with multiple members per fax will be returned to the provider and not processed. Minimum Information Required to Process a Request Providers must use the Texas Standard Prior Authorization Request Form*, which can be found at https://www.texaschildrenshealthplan.org/for-providers. Click on Downloadable Forms on the left-hand side, then click Standard Prior Authorization Form or Behavioral Health Authorization Form to download. The following essential information is required to start the authorization process:
  • Member Name, Member Date of Birth, and Member Medicaid/CHIP ID
  • Requesting Provider’s Name and Requesting Provider’s NPI Number
  • Rendering Provider’s Name and Rendering Provider’s NPI Number
  • Service Requested CPT code, Number of Units Requested, and Dates of Service Requested
Texas Children’s Health Plan may return an incomplete prior authorization request when the form does not contain all of the essential information listed above and request that the provider resubmit the request with all of the appropriate information included. Processing of the authorization will not begin until all essential information is received. Duplicate Authorization Requests All prior authorization requests are subject to a duplicate review. Prior authorization requests that are a duplicate of a previously submitted authorization request will be returned to the provider. The request will be closed as a duplicate request. If applicable, for denied service requests, the Texas Children’s Health Plan internal appeal process and appropriate external review processes are available to members and providers. Requests to Close a Pending Authorization If a provider or member requests to close/withdraw a prior authorization request that is in process and Texas Children’s Health Plan has not made a determination, the provider or member must submit the request to Texas Children’s Health Plan in writing and include the following information:
  • Date of the withdrawal request
  • Person’s name and contact information making the request
  • Reason for the withdrawal of the request
Transition Process Texas Children’s Health Plan will allow providers a 30-day grace period to comply with these procedures. *Texas Children’s Health Plan will allow a 90-day grace period to comply with exclusive use of the Texas Standard Prior Authorization Request Form.