SNIP Level Edits Announcement

Date: May 2, 2025

Attention: Providers

Effective date: May 19, 2025

Call to action: Texas Children’s Health Plan (TCHP) would like to inform you that we will be initiating Strategic National Implementation Process (SNIP) Level edits 3-7 in the upcoming release effective May 19, 2025. During last year’s Change Health Care outage, when we transitioned to the Availity Lifeline contract, only SNIP Level edits 1-2 were included.

As part of our ongoing updates, we are now activating the additional SNIP Level edits, 3-7. Going forward, after the effective date of May 19, 2025 you will begin to see claims being rejected at the clearinghouse level, if they are billed incorrectly rather than receiving a denied claim.

How this impacts providers: SNIP Level edits included in the latest update.

Type 3: Balancing
Type 4: Situation testing
Type 5: External code set testing
Type 6: Product types or line of services
Type 7: Implementation Guide-Specific Trading Partners

Operational Support
Availity Customer Support (ACS) supports providers with all Availity Essentials Portal actions. Provider’s clearinghouse are welcome to contact Availity at 1-800-282-4548 for one of the reasons below. Availity call center is available Monday – Friday, 8am to 8pm EST. Examples include:

Portal registration
User access/ Account assistance
Transaction submissions
Portal error messages
Claim rejection

Texas Children’s Health Plan Call Center supports providers with all ‘data’ related provider inquiries. Providers can contact the Call Center at 832-828-1004 or toll-free at 1-800-731-8527.
Examples include:

Claim denial
Benefit coverage details
Prior Authorization details
Claim payment questions
Network details

Next step for Providers: Providers should share this communication with their billing staff and clearinghouse.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.

For access to all provider alerts: www.texaschildrenshealthplan.org/provideralerts.