Extensive Case Management Programs Available for Members

Date: July 25, 2023

Attention: All Providers

Call to action: Texas Children’s Health Plan (TCHP) would like to remind providers that extensive case management and service coordination programs are available to our members. In addition, several virtual classes are offered to our members in English and Spanish.

Our case managers play an important role in assisting our members with obtaining the necessary medical and/or behavioral health care, support, resources and services they need to achieve the best possible health outcomes. 

How this impacts providers: TCHP relies on providers like you to identify and refer your patients to our case management programs. For our behavioral health members for example, please consider referring members who are at risk for self-harm, substance use disorders, and/or whom have a diagnosis of bipolar disorder or major depressive disorder. 

Our case management programs include:

• Asthma
• Behavioral Health Case Management
• Complex Case Management
• Diabetes
• Maternity/Women’s Health Case Management
• Education and Support Classes. TCHP offers the following virtual classes in English and Spanish for all eligible members:
  • Understanding Pregnancy, Understanding Birth, Understanding Breastfeeding, Understanding Postpartum Health and Baby Care, and Understanding Your Newborn. Learn more
  • My Healthy Plate nutrition course
• One-on-one telephonic health coaching to member and/or caregiver (included with all Case Management programs)
• Referral for Supplemental Security Income (SSI)

To refer a patient to our case management program, please fill out the Member Referral for Case Management form in its entirety and include a detailed referral reason and the case management program you are referring your patient to. Please provide your contact information as well should we have questions and for continuity of care. If you have any questions, please contact your Provider Relations Liaison (PRL) or CaseManagementPhysicianReferral@texaschildrenshospital.org. Our case manager(s) will reach out to the member, address the referral and offer case management. Enrollment in case management is voluntary for STAR/CHIP members. 

Note: If the patient you are providing care for is a STAR Kids member with TCHP, your patient should have an assigned service coordinator who manages their medical and/or behavioral health case management needs. If you have something specific for the STAR Kids service coordinator to address, please indicate the need in the referral reason portion of the form. 

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

Resources: 

• Member Referral for Case Management 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