Upcoming Annual HEDIS Medical Record Review

Date: January 9, 2026

Attention: All Providers

Review Period: January – April 2026

Call to action: Texas Children’s Health Plan (TCHP) would like to inform network providers that the Healthcare Effectiveness and Data Information Set (HEDIS) medical record data review process will begin this month (January 2026) and continue through April 20, 2026. We have contracted with Virtix Health, a wholly owned subsidiary of Inovalon, Inc., to retrieve medical records and perform HEDIS medical record data abstraction on our behalf. 

All medical records must be submitted to Virtix Health no later than Monday, April 20, 2026. Please note the following:

• Virtix Health serves as TCHP’s Business Associate, as that term is defined by the Health Insurance Portability and Accountability Act (HIPAA).
• Virtix Health is ethically and legally bound to protect, preserve and maintain the confidentiality of any Protected Health Information (PHI) collected from clinical records provided by medical practice locations pursuant to its contractual obligations to TCHP.
• PHI that is used or disclosed for purposes of treatment, payment or health care operations is permitted by HIPAA and does not require consent or authorization from the member/patient.
• In this setting, please be assured that Virtix Health will treat your patients’ PHI with the utmost protection and confidentiality.

Information for submitting medical records: Virtix Health will contact your office to request copies of chart components to be sent via fax, mail, or through the secure provider portal for review. For any questions regarding the requested information or data collection process, please contact Virtix Health.

Virtix Health’s contact information is below:
Phone: 800-405-4426
Fax: 956-368-7983
Mail:
Virtix Health Client Record Processing
6509 Windcrest Dr. Suite 165
Plano, TX 75024
Provider Portal: cclinxportal.virtixhealth.com
(Providers will receive a cover sheet with your username and password details to access the portal)

Next step for providers: Please reply to any requests from Virtix Health within 3 to 5 business days, as this is a time-sensitive project. 

Virtix Health is committed to the protection of all patient information and reminds providers to carefully follow the instructions in the request to ensure accurate data is provided while adhering to the minimum information release guidelines.

Providers are encouraged to inform their staff of this communication. Providers can contact their Account Lead or Provider Relations Liaison (PRL) to address any questions or concerns about this process. If you’re unsure who your Account Lead or PRL is, please visit https://www.texaschildrenshealthplan.org/for-providers/meet-our-team.

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

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