Good news! We’ve made it easier for Texas Children’s Health Plan members to log in to the MyChart website. Now, you can access all your MyChart health care features anytime, anywhere using our new sign-in widget. Click the link to log in now
¡Buenas noticias! Hemos hecho más fácil el inicio de sesión en MyChart para nuestros miembros de Texas Children’s Health Plan. Ahora puedes acceder a todas las funciones de cuidado médico de MyChart en cualquier momento y desde cualquier lugar mediante nuestro nuevo widget de inicio de sesión. Haz clic en el enlace para iniciar sesión.
Important UpdateActualización importante:
Good news! All CHIP, STAR, and STAR Kids Member Handbooks are now available online. Quick, easy access to your benefits and coverage information - any time!
¡Buenas noticias! Todos los manuales para miembros de CHIP, STAR y STAR Kids ya están disponibles en línea. Obtén acceso rápido y sencillo a la información sobre tus beneficios y cobertura, ¡en cualquier momento!
Call to action: The purpose of this communication is to notify providers that Texas Children’s Health Plan (TCHP) will update its claim overpayment processing logic within the claims processing system, Epic Tapestry. The updated configuration implements automated recovery rules for any downward adjusted (re-adjudicated) claim to determine whether it routes to:
Standard Automatic Recoupment (offset against future remits), or
Approved Refund Request Process (formal refund demand letter/check request).
How this impacts providers: Standard Automatic Recoupment Process When a claim is downward adjusted, Epic Tapestry will automatically evaluate provider exception status and route the account through the standard recoupment workflow:
Non-Exception Providers: If the rendering/billing provider is not on the approved exception list, Epic immediately sets the claim status to Ready for Recoupment.
Once set to Ready for Recoupment, the overpayment balance routes directly to the standard automatic recoupment process against future remittance disbursements.
There is no minimum dollar threshold for recovery. Downward adjustments of any dollar amount will trigger automatic recoupment.
Approved refund-request exceptions While standard downward-adjusted claims trigger automatic offset/takeback, select providers are exempt from automatic recoupment due to contractual agreements or provider-specific accounting policies:
Approved Exception Providers: If a downward-adjusted claim is linked to a provider on the approved exception list, Epic Tapestry bypasses automatic recoupment.
Status Assignment: Epic assigns the account a Ready for Refund status (instead of Ready for Recoupment).
Example of a standard exception A claim involving an OIG payment hold will not proceed through automatic recoupment.
Exempt providers will be made aware of this status by their assigned Provider Relations Account Lead or Liaison.
Next step for Providers: Providers should share this communication with their billing staff.
