A State Fair Hearing is a chance for you tell the reasons why you think the services you asked for and couldn’t get should be allowed.
Can I ask for a State Fair Hearing? If you, as a member of Texas Children’s Health Plan, disagree with the health plan’s decision, you have the right to ask for a fair hearing. You may name someone to represent you by writing a letter to the health plan telling them the name of the person you want to represent you. A doctor or other medical provider may be your representative. If you want to challenge a decision made by Texas Children’s Health Plan, you or your representative must ask for the fair hearing at any time up until 90 days of the date on the health plan’s letter with the decision. If you do not ask for the fair hearing within 90 days, you may lose your right to a State Fair Hearing.To ask for a fair hearing, you or your representative should either send a letter to the health plan or call:
Texas Children’s Health Plan
Attention: Appeals Department NB8390
PO Box 300709
Houston, TX 77230
Phone: 832-828-1001 or 1-866-959-2555
TDD 1-800-735-2989 (Texas Relay) or 7-1-1