UPDATE: Real-Time Eligibility (RTE) Now Available Through Availity

Date: August 27, 2025

Attention: Providers

Effective date: September 2, 2025

Call to action: We are pleased to announce that Real-Time Eligibility (RTE) functionality to check your patients (or our member’s) eligibility status in real time has been re-enabled through our clearinghouse partner, Availity.

How this impacts providers: Effective September 2, 2025, providers can once again submit ANSI X12 270/271 eligibility transactions and receive eligibility results and details in real time—just as previously done with Change Healthcare.

To access RTE services:

Use Payer ID: TXCPL
Submit eligibility inquiries (270) via Availity
Receive eligibility responses (271) with up-to-date member benefit information

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.