UPDATE: Recent Claim Denials Issued in Error are now Corrected

Date: March 23, 2023

Attention: All Providers

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that we have corrected the internal system error that was previously reported. The error impacted claims processing beginning February 27- March 7, 2023. All impacted claims from this time span have been reprocessed. The erroneous EOP message related to these claims was, “This Provider was not certified/eligible to be paid for this procedure/service on this date of service.”

Claims impact report: Your assigned Provider Relations Liaison (PRL) will be contacting you over the next week with your claims impact report. Providers are also welcome to reach out to their assigned PRL for this information. If you are not aware of your assigned PRL, please email providerrelations@texaschildrens.org and we will respond with their name and contact information.

Next steps for providers: No action is required by Providers. Providers are not required to appeal the claims unless they are denied for other reasons after the claims reprocessing is complete.

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.