Texas Children’s Link Update – Prior Authorizations

Date: August 5, 2022 Attention: All Providers Providers 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 providers that we are currently experiencing Utilization Management (UM) system delays and this issue is affecting our ability to process Prior Authorization requests. The UM team is working to prioritize urgent requests and we will keep you updated. How this impacts providers: Providers are encouraged to submit authorization requests on Texas Children’s Link since this is the most efficient way for our team to process authorizations. Important benefits of using the new portal to submit authorizations include:

• Faster Authorization Processing – Prior Authorization requests received in the portal are assessed by the UM team faster than any other method

• Real-time Access to Authorization Status Information – Authorization Status Update and Status History are immediately available and determinations can be reviewed on the portal in real-time

• Auto Authorizations for Certain Services – Certain services and supplies such as medically necessary nutritional supplements, general anesthesia for dental procedures and targeted case management can be submitted for auto authorizations

• Easy Access for Providers and Staff – In addition to providers, both clinical staff and non-clinical staff may submit and review authorization requests on the portal on behalf of a requesting provider. For more information on the ease of using our new portal, watch the how-to videos on the portal linked at the bottom of the page under “Quick Links”

Non-clinical Users Update Our team identified that initially non-clinical users were not able to submit Prior Authorizations or claims, but this optimization has been addressed and non-clinical users now have access. We appreciate the feedback received to assist us. This functionality can now be accessed by all non-clinical portal users. Next steps for providers: Providers should share this communication with their staff. 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.