Date: June 22, 2023
Attention: All Providers
Effective date: July 1, 2023
Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers of a recent update to the prior authorization fax lines. On July 1, 2023, a new line will be added. This fax line will be used to send in authorization requests for members who are hospitalized at the time of request and services or equipment that are necessary for care of the member immediately after discharge. Requests unrelated to discharge needs should not be sent to this number.
New fax line effective July 1, 2023:
- Post Hospital Discharge Authorizations Fax Line – Toll-Free 866-839-9879
How this impacts providers:
Providers should send in authorization requests for members who need services after an inpatient admission to the new fax line starting July 1, 2023.
A reminder about the other fax lines:
- Medical Inpatient Admissions and Discharge Notifications - 832-825-8462 or Toll-Free 844-663-7071
- 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
Next steps for providers: Providers should share this communication with their staff.
Resources:
Prior Authorization Information
Prior Authorization Form
If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.
For access to all provider alerts,log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.
