Skip to main content
Dismiss notification

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

Expand notification
Dismiss notification

Retiro voluntario del mercado de fórmula infantil en polvo Nutramigen LGG | Haz clic aquí para saber más

Expand notification

Help Your Patients Stay Covered

Learn how to help your patients with renewing their coverage

Learn more

For Providers

Attention Providers!

Texas Children’s Health Plan (TCHP) is highlighting May as Behavioral Health Awareness Month.

Learn more

Texas Children’s Health Plan (TCHP) would like to provide an update regarding Optum’s recent Change Healthcare network interruption. In an effort to mitigate the financial impact to our providers, TCHP has activated an alternative payment process that will be in effect until Optum’s Change Healthcare process is restored. Click here to view the Provider Alert.

  • The Vendor Drug Program (VDP) will make changes to the Texas Medicaid drug formulary. This is in effect as of January 26, 2024 on select medication(s) moving from “preferred” to “non-preferred” status and vice-versa. To learn more about formulary changes impacted, please click here for more information.
  • 2023-24 RSV Season Updates, please click here to view the Provider Alert.

Network providers must maintain their enrollment and demographic information with Texas Medicaid Healthcare Partnership (TMHP). Provider Medicaid enrollment functions are available through Provider Enrollment and Management System (PEMS). Updates to provider’s current enrollment, new practice locations or change of ownership updates, can be made on this site titled ”Provider Enrollment and Management System (PEMS)”, accessible here.

For instructions on how to make other demographic updates to your current enrollment, access the site titled “Provider Enrollment Help”, accessible here.

Click here to view the Provider Alert.

Our website for providers is designed as a tool to help you. You can find an array of resources such as:

Provider Manuals

Helpful links

Member Rights and Responsibilities 

Clinical and Administrative Advisory Committee, Behavioral Health Advisory Committee, Perinatal Advisory Committee

These Provider Advisory Groups provide recommendations to Texas Children’s Health Plan in the following areas:

  • Identification and review of clinical practice guidelines and prior authorization guidelines;
  • Review of general utilization patterns and assessment of Provider compliance with clinical guidelines;
  • Recommendations for member engagement and quality improvement programs to improve health outcomes and keep members healthy
  • Strategies and recommendations for improving Health Plan administrative processes;
  • Recommendations on how to improve care based on Member feedback and their personal experiences serving our Members; and
  • Opportunities for connecting network Providers and Managed Care Organization clinical experts for purposes of peer support and sharing best practices.

There is a Clinical and Administrative Advisory Committee for each of our three Service Areas:

  • Harris
  • Jefferson
  • Rural Service Area Northeast

The Behavioral Health Advisory Committee and Perinatal Advisory Committee meet in the Harris Service Area.

The meeting cadence for each of the committees are as follows:

  • Clinical and Administrative Advisory Committee meets 9 times per year in the Harris Service Area and quarterly in the Jefferson and Rural  Service Area Northeast
  • Behavioral Health Advisory Committee meets quarterly
  • Perinatal Advisory Committee meets quarterly