Provider Alert! Provider Portal Provides Instant Access to Claims and Member Information

Date: April 22, 2022

 Attention: All Providers

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated with the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

TCHP will apply updates and reprocess impacted claims as soon as possible. However, please allow up to sixty (60) business days for reprocessing. Providers are not required to appeal claims unless denied for other reasons.

Call to action: TCHP would like to remind providers of the information easily accessible by accessing our online resources.
Provider Portal
http://texaschildrenshealthplan.org/for-providers to log into the Provider Portal.
Features include:

• Member eligibility
• Claim submissions- both individual and batch
• Claim status
• Claim appeals
• Access to Healthcare Effectiveness Data and Information Set (HEDIS®) data through Inovalon Population management software, offering insights to quality performance
• Access to forms to update demographic information
• Reports with improved descriptions and instructions
• Online prior authorization requests and status
• Provider resources and education

Resources:

Provider portal training guide is available here.

Online prior authorization user guide is available here.

New network providers can register for the portal by accessing this link: https://www.healthtrioconnect.com/register/nonmember/userinfo/UserInformation?payor=1035&portal=Provider. Registrants will be required to enter information such as your Tax Identification Number (TIN), provider National Provider Identifier (NPI), contact name and email address. Once you complete and submit the registration form, you will receive an email confirmation to validate your account. Multiple staff members within one office or group can have an account. Each user within the office must create their own unique user name and password. Sharing accounts between staff is not permitted.

Please check with your office administrator before registering to determine if your practice has portal access. If your practice already has portal access, the administrator can simply add you to the existing account for the practice.

Find a Doctor

Easily find a TCHP network physician or ancillary provider by accessing our online Find a Doctor resource.
https://www.texaschildrenshealthplan.org/doctor

For help with using the online directory click here for the user guide.

Next steps for providers: Providers should access the available resources as described here and contact their Provider Relations Liaison should they need further assistance. The contact information for the Provider Relations Liaisons can be found here, https://www.texaschildrenshealthplan.org/for-providers/meet-our-team.

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.