New Online Authorization Platform for Providers

Attention: All ProvidersEffective Date: January 1, 2021Providers 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: Texas Children’s Health Plan (TCHP) would like to inform our network providers that currently have access to Clear Coverage, our online authorization tool, that beginning January 1, 2021; Clear Coverage will no longer be available. Health Trio will replace Clear Coverage for online authorization submissions. To make the transition easier, your assigned Provider Relations Liaison will be in touch with you to provide training and address any questions you may have. The same functionality will remain intact when we move to the new platform and providers will not have to take any action in order to gain access to Health Trio. It will be accessible on the provider portal as Clear Coverage is today. How this impacts providers: The features and benefits that providers will experience with Health Trio are as follows:

• Simplified form to complete for authorization requests
• Easier process to add attachments to requests
• Continue to provide automatic approvals for some genetic testing and dental anesthesia, provided the medical criteria is met. Detailed information on the auto-approve criteria is available in the training guide.
• The turnaround time for prior authorization determinations will remain the same
• There is no change in the notification process. Users will still receive a fax notification of the outcome and be able to check authorization status online in the Provider Portal.

Next steps for providers: Providers should inform their staff of this change and be on the lookout for communication from their assigned Provider Relations Liaison. Feel free to contact your Provider Relations Liaison if you would like to engage in training so your staff is ready for Health Trio on January 1, 2021. Health Trio Prior Authorization Request Training Guide The contact information for the Provider Relations Liaison in your area is available here. 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.