Date: May 2, 2025
Attention: Providers
Effective date: May 19, 2025
Call to action: Texas Children’s Health Plan (TCHP) would like to inform you that we will be initiating Strategic National Implementation Process (SNIP) Level edits 3-7 in the upcoming release effective May 19, 2025. During last year’s Change Health Care outage, when we transitioned to the Availity Lifeline contract, only SNIP Level edits 1-2 were included.
As part of our ongoing updates, we are now activating the additional SNIP Level edits, 3-7. Going forward, after the effective date of May 19, 2025 you will begin to see claims being rejected at the clearinghouse level, if they are billed incorrectly rather than receiving a denied claim.
How this impacts providers: SNIP Level edits included in the latest update.
- Type 3: Balancing
- Type 4: Situation testing
- Type 5: External code set testing
- Type 6: Product types or line of services
- Type 7: Implementation Guide-Specific Trading Partners
Operational Support
Availity Customer Support (ACS) supports providers with all Availity Essentials Portal actions. Provider’s clearinghouse are welcome to contact Availity at 1-800-282-4548 for one of the reasons below. Availity call center is available Monday – Friday, 8am to 8pm EST. Examples include:
- Portal registration
- User access/ Account assistance
- Transaction submissions
- Portal error messages
- Claim rejection
Texas Children’s Health Plan Call Center supports providers with all ‘data’ related provider inquiries. Providers can contact the Call Center at 832-828-1004 or toll-free at 1-800-731-8527.
Examples include:
- Claim denial
- Benefit coverage details
- Prior Authorization details
- Claim payment questions
- Network details
Next step for Providers: Providers should share this communication with their billing staff and clearinghouse.
If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org.
For access to all provider alerts: www.texaschildrenshealthplan.org/provideralerts.
