Texas Children's Health Plan will be closed on Monday, September 1st, in observance of Labor Day. In our absence, you can reach our after-hours nurse help line at 1-800-686-3831. We will resume normal business hours on Tuesday, September 2nd. Wishing you a safe and happy Labor Day!
Texas Children's Health Plan estará cerrado el lunes 1 de septiembre por el Día del Trabajo. Durante nuestra ausencia, puedes comunicarse con nuestra línea telefónica de ayuda fuera del horario habitual al 1-800-686-3831. Reanudaremos nuestro horario regular el martes 2 de septiembre. ¡Te deseamos un feliz y seguro Día del Trabajo!
New Rewards Coming Soon!¡Se vienen nuevas recompensas!
Our Healthy Rewards Program is getting an update in September! For a sneak peek of all the changes - including new rewards and ways to redeem them - please click here.
¡Nuestro Programa Healthy Rewards tendrá su actualización en septiembre! Para ver un adelanto de todos los cambios, incluyendo nuevas recompensas y formas de canjearlas, haz clic aquí.
Appointment Availability Standards Reminder for 2025
Date: July 18, 2025
Attention: Primary Care and Obstetric Care Providers
Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers of the appointment availability standards. Senate Bill 760 passed, requiring Texas Health and Human Services Commission (HHSC) to monitor the provider networks of managed care organizations. Texas Children’s Health Plan would like to ensure members are able to schedule appointments with providers in accordance with the HHSC’s appointment accessibility guidelines.
Provider Type
Level/Type of Care
Appointment Accessibility Standards
OB/GYN
Low Risk Pregnancies
Provided within 14 calendar days
High Risk Pregnancies
Offered within 5 calendar days
New Members in the Third Trimester
Offered within 5 days
Primary Care
Urgent care
Within 24 hours
Emergency Care visit
Immediately or refer to ER
Routine primary care
Within 14 days
New child Member (< 20 years old) or adult preventive appointment
Within 90 calendar days
How this impacts providers: Texas Children’s Health Plan enforces access and other network standards required by the contract and takes appropriate action with providers whose performance is determined by the health plan to be out of compliance. In addition, providers and staff are responsible for understanding the requirements.
Primary Care Providers, a reminder that a referral is not required to see a TCHP in-network specialist.
Next step for Providers: Providers should share the appointment availability standards with their staff and if needed, implement internal procedures for compliance.
