News Blog

Provider Alert! Health Advisory Issued on Mumps Outbreaks in Texas

The Texas Department of State Health Services issued a Health Advisory on 11/30/2016 due to two outbreaks of mumps in North Central Texas. An outbreak in Dallas County involves 5 adults and a Johnson City outbreak involves 10 cases, mostly in children. Several other outbreaks have occurred in the US outside of Texas. DSHS requests that physicians "please consider mumps as a diagnosis for any patients presenting with the following symptoms, particularly those who have traveled out of the state or [...]

Provider Demographics

Texas Children’s Health Plan is required to provide members with online access to updated provider information. To do this, Texas Children’s Health Plan requires that providers update their demographics whenever there is a change in hours, address, days of week and languages provided. There are multiple ways to notify Texas Children’s Health Plan of these changes. Providers can email Texas Children’s Health Plan at, they can send a message to, fax the change information to 832-725-8750, or [...]

Texas Children’s Health Plan CMOs introduces STAR Kids

Over the past year and a half, the Texas Children’s Health Plan has been preparing for STAR Kids. This program will offer families with medically complex children the advantage of increased care coordination as part of Medicaid Managed Care. Some of the incredible numbers: 250+ new care coordinators hired and trained by Texas Children’s Health Plan 2,000 new providers added to our network 30,000 new members expected STAR Kids will offer providers additional support and help to reduce the many hassles we run [...]

Provider Alert! All Texas Children’s Health Plan providers and facilities Utilization Management Guidelines effective November 1, 2016

Texas Children’s Health Plan has developed Utilization Management guidelines that serve as criteria for the determination of medical necessity for services that require prior authorization. These guidelines will be effective on November 1, 2016. The goal of Texas Children’s Health Plan’s Utilization Management guidelines is to encourage the highest quality care from the right provider in the right setting. Utilization Management guidelines are available for you to review. Please contact Texas Children’s Health Plan’s Provider Relations department at 832-828-1008 or toll-free [...]

Provider Alert! Upcoming Texas Children’s Health Plan Provider TouCHPoint portal changes allows providers to submit claims electronically

In the coming weeks, Texas Children’s Health Plan will make available batch claims submission via the Texas Children’s Health Plan Provider TouCHPoint portal. This will be a free service to providers and will accept batch claims as well as appeals with supporting documentation. Please watch for more information posted on TCHP Provider TouCHPoint.

Upcoming Texas Children’s Health Plan Provider TouCHPoint portal changes: Provider Attestation required

The Texas Children’s Health Plan Provider portal is changing. In order to be compliant with HHSC guidelines to confirm provider demographic information, the Texas Children’s Health Plan Provider portal will require a quarterly attestation of information by NPI number. If access to the secure portal has been blocked because of needed attestation, users will not be able to access the portal until an office administrator for the account attests the information on file. Only staff with office administrator-level access can [...]

Changes to the Sterilization Consent Form and Instructions, Approval Process, and Denial Letter

Changes to the Sterilization Consent Form and Instructions, Approval Process, and Denial Letter Information posted July 15, 2016 Note: This article applies to transactions submitted to TMHP for processing. For transactions processed by a Medicaid managed care organization (MCO), providers must refer to the MCO for information about benefits, limitations, prior authorization, and reimbursement. Effective September 1, 2016, the following changes will be made to the Sterilization Consent Form and corresponding instructions, the Sterilization Consent Form Denial Letter, and the process that [...]

Undescended Testicles and the Use of Ultrasound

Cryptorchidism or undescended testis (UDT) is the most common urological birth defect, occurring in 1 in 33 live male births. The most important reasons for surgical treatment of cryptorchidism include increased risks of testicular malignancy, infertility, testis torsion and/or inguinal hernia. The current standard of treatment for any UDT that fails to spontaneously descend by 6 months of age in the United States is orchidopexy (surgery to reposition the testis to the scrotum). Evaluation of UDT includes a thorough [...]

THSteps Checkup Documentation — Essential to Medical Records

As a Texas Health Steps (THSteps) provider you affect the lives of many young Texans. The care you provide helps prevent serious or chronic health-care problems and often helps young patients begin to develop positive lifelong health-care habits. Being a THSteps provider can be very rewarding. It can also be very challenging, especially when it comes to medical checkup documentation. Independent studies of Texas Health Steps medical checkups indicate that records were most commonly missing documentation of appropriate laboratory [...]

Additional electronic payments offered with Virtual Credit Card option

You now have an additional payment option The Virtual Credit Card (VCC) has been made available through ChangeHealth, previously known as Emdeon. This option is available for all providers. VCC allows providers to accept a virtual payment instead of a paper check or electronic funds transfers. When you use VCC, providers will receive a unique 16-digit credit card number for every payment made by Texas Children’s Health Plan. That number is then keyed into your credit card terminal to [...]