For Providers

Our website for providers is designed as a tool to help you. You can find an array of resources such as:

• Pharmacy Directories
• Downloadable forms
• Claims information
• Practice guidelines
• Provider Newsletters
• Contracting and Credentialing

Provider Resources

• CHIP / STAR Provider Manual
• STAR Kids Provider Manual
• Prior Authorization Information
• TCHP Institutional Companion Guide
• TCHP Professional Companion Guide 

Helpful links

• Medicaid Autism Services Flyer: Applied Behavior Analysis Services
• Screening and Coding for Social Determinants of Health
• Texas Health and Human Services
• Texas Health Steps Culturally Effective Health Care online course
• Texas Health Steps Additional Courses
• Texas Health Steps Provider Information
• Texas Health Steps Regional Representative Contact List
• Texas Medicaid/CHIP Vendor Drug Program
• Texas Medicaid & Healthcare Partnership

Member Rights and Responsibilities 

• CHIP Members
• STAR Members
• STAR Kids Members

Clinical and Administrative Advisory Committee, Behavioral Health Advisory Committee, Perinatal Advisory Committee

These Provider Advisory Groups provide recommendations to Texas Children’s Health Plan in the following areas:

• Identification and review of clinical practice guidelines and prior authorization guidelines;
• Review of general utilization patterns and assessment of Provider compliance with clinical guidelines;
• Recommendations for member engagement and quality improvement programs to improve health outcomes and keep members healthy
• Strategies and recommendations for improving Health Plan administrative processes;
• Recommendations on how to improve care based on Member feedback and their personal experiences serving our Members; and
• Opportunities for connecting network Providers and Managed Care Organization clinical experts for purposes of peer support and sharing best practices.

There is a Clinical and Administrative Advisory Committee for each of our three Service Areas:

• Harris
• Jefferson
• Rural Service Area Northeast

The Behavioral Health Advisory Committee and Perinatal Advisory Committee meet in the Harris Service Area.

The meeting cadence for each of the committees are as follows:

• Clinical and Administrative Advisory Committee meets 9 times per year in the Harris Service Area and quarterly in the Jefferson and Rural  Service Area Northeast
• Behavioral Health Advisory Committee meets quarterly
• Perinatal Advisory Committee meets quarterly