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Date: September 9, 2024
Attention: All Providers
Updated PEMS Go-Live Date: May 30, 2025
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that the effective date for Provider Enrollment and Management System (PEMS) is now May 30, 2025. The collaborative testing between Managed Care Organizations (MCOs) and Health and Human Services Commission (HHSC) determined that there are some providers with mismatched addresses in PEMS. The providers with these mismatched addresses in our network will receive communication directly from TCHP.
How this impacts providers: The communication from TCHP will include the following information:
Providers that neglect to update their address information within the specified period will experience the following consequences:
TCHP along with all other MCOs must report completion metrics to HHSC to help measure the address synchronization between the MCOs and PEMS. The report will include:
Next step for Providers: Providers must follow the PEMS guidance provided in this communication. Meeting the address synchronization between MCOs and PEMS will proportionately reduce claim denials for providers and improve the accuracy of encounter reporting and network adequacy to MCOs.
If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.
For access to all provider alerts,log into:
www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts or www.texaschildrenshealthplan.org/for-providers.