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Cold and flu season Temporada de influenza y resfriados

ALERT: Stay healthy this cold and flu season! Learn more

ALERTA: ¡Mantente sano durante esta temporada de influenza y resfriados! Más información

New Website! ¡Nuevo sitio web!

ALERT: We have made the Texas Children’s Health Plan website even easier to use! Click here to learn more.

ALERTA: ¡Ahora el sitio web de Texas Children’s Health Plan es aún más sencillo de usar! Haz clic aquí para más información.

Enfamil shortage updates Escasez de Enfamil Reguline

ALERT: Shortage of Enfamil products until October 31, 2024. Learn more.

ALERTA: Escasez de productos de Enfamil hasta el 31 de octubre de 2024. Más información.

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Becoming a Participating Provider

If you are currently participating in the Texas Children’s Health Plan network, please find additional information on how to navigate the Contracting Gateway system here.

Providers joining an existing provider group may qualify for expedited credentialing. Click here for more information

Becoming a Participating Provider

How to join Texas Children's Health Plan Provider Network 

Thank you for your interest in joining the Texas Children’s Health Plan network. In order to submit a request for consideration, please complete the following steps:

  1. Create a New Provider Record via TCHP Contracting Gateway at cobblestonegateway.texaschildrens.org
    • New Users are required to create a New Provider Account in TCHP’s Contracting Gateway.
       
  2. Request New Provider Agreement
    • Once a new account is activated, please allow 10 minutes for account activation prior to submitting a New Provider Agreement Request.
    • New Provider Agreement requests require W9 and provider roster; provided below.
    • Roster template
    • W9 website
    • Step by step instructions for TCHP’s Contracting Gateway can be accessed using the following link: Cobblestone Gateway User Guide
    • Credentialing requirements and process can be found in TCHP’s Provider Manual. Our Credentialing Verification Organization is Verisys Corp. Please be advised of the following practitioner rights under NCQA for practitioners who are undergoing the credentialing process:
      • Practitioners have the right to review information submitted by outside sources (malpractice insurance carriers, state licensing boards, etc.) to support their credentialing application. Texas Children’s Health Plan is not required to make available references, recommendations or peer review protected information.
      • Practitioners have the right to correct erroneous information identified in their credentialing application. Corrections must be submitted in writing to the Texas Children’s Health Plan Credentialing Department at CredentialingResponse@texaschildrens.org within (10) days.
      • Practitioners have the right to receive the status of their credentialing or re-credentialing application, upon request, by emailing the Credentialing Department at CredentialingResponse@texaschildrens.org. Please note that all credentialing applications are processed by Verisys, the state-mandated CVO. It is imperative that providers respond promptly to all correspondence received from Verisys to ensure timely processing of the credentialing application. If a practitioner inquires about the status of their credentialing application, the credentialing staff will review the practitioner’s CAQH application and the status of the credentialing file, including pending and/or completed primary source verifications with Verisys. Information that is allowed to be shared with practitioners include, but is not limited to, information the provider submitted during the credentialing application process and discrepancies with state enrollment that may delay the process. TCHP is not allowed to share any information protected by applicable peer review law (i.e. NPDB queries). Once the staff determines the completeness and anticipation of credentialing committee review timeframe, the provider will be notified of their credentialing status via email. Credentialing status inquiries received via the provider hotline, will be forwarded by member services to the credentialing department.

        For inquiries please contact TCHP's Contracting Department
        Phone: 1-832-828-1004, option 6
        Email: TCHPNetworkManagement@texaschildrens.org
        Fax: 1-832-825-9360
         
    • For questions on the Contract Gateway process, please contact the Contracting Department via at tchpnetworkmanagement@texaschildrens.org

      For all other inquiries please contact Provider Network Management: 

      Provider Network Management:
      1-832-828-1004, option 6
      Fax: 1-832-825-9360

      Texas Children's Health Plan operates in the following service delivery areas:

      Areas of Operation
      Open Map
       

  3. New Provider Orientation

    The assigned Provider Relations Manager will contact new providers to schedule an in-service for your office regarding Texas Children’s Health Plan’s policies and procedures.