Provider Alert! New Prior Authorization Fax Line for Medical Inpatient Admissions and Discharge Notifications Authorization Reminders

Date: July 27, 2022

Attention: All Providers

Effective date: August 1, 2022

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to 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.

Call to action:  TCHP would like to inform you of a recent update to the prior authorization fax lines. New lines will be added for notification for medical inpatient admissions and hospital discharges.

New fax lines effective August 1, 2022

• Medical Inpatient Admissions and Discharge Notifications

Toll-Free 844-663-7071 or 832-825-8462

How this impacts providers:

Providers should send medical inpatient admissions and discharge notifications to the new fax line starting 8/1/2022.

Note: TCHP will process admission notifications and discharges that are routed in error to the medical services fax line.

A reminder about the other fax lines:

• Medical Services Fax Line – 832-825-8760 or Toll-Free 1-844-473-6860
• Behavioral Health Services Fax Line – 832-825-8767 or Toll-Free 1-844-291-7505
• LTSS and Private Duty Nursing Fax Line – 346-232-4757 or Toll-Free 1-844-248-1567

Prior Authorization Determinations

The Utilization Management department processes service requests in accordance with the clinical immediacy of the requested services.

Authorization | Turnaround Time

Routine | Within 3 business days after receipt of request

Urgent | Within 1 business day after receipt of request

Inpatient | Within 1 business day after receipt of request

Life-threatening conditions | within one hour
Post hospital discharge services | within one business day

TCHP does not require prior authorization for Emergency Medical Conditions or Emergency Behavioral Health Conditions.

Next steps for providers: Providers should share this communication with their staff.

Resources:

Prior authorization form 

TCHP prior authorization information 

Provider alerts related to the authorization information mentioned above:
http://www.thecheckup.org/2020/06/10/provider-alert-update-updates-to-prior-authorization-requirements/

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