For a printable PDF of our Provider Quick Reference Guide, please click here.
Phone: 832-828-1004
Toll free: 1-800-731-8527
Telephone TouCHPoint: 832-828-1007
Fax: 832-825-8750
Suspected fraud, waste or abuse (FWA) by recipients or providers can be reported to the Office of Inspector General (OIG) and/or Texas Children’s Health Plan’s Special Investigations Unit (SIU). Texas Children’s Health Plan’s Fraud, Waste, and Abuse Hotline is a dedicated resource designed specifically for our Network Providers. We understand the critical importance of maintaining the highest standards of integrity and compliance within our healthcare network. The hotline is 866-828-4924, or visit https://tchpintegrity.com/.
You can reach Texas Children’s Health Plan Controls and Compliance Department at 832-828-1320
Fax Number: 832-825-8722
Email: TCHPSIU@texaschildrens.org
Office of Inspector General: FWA Reporting
Website: https://oig.hhsc.texas.gov/report-fraud-waste-or-abuse
Monday - Friday 8:00 a.m. - 5:00 p.m. Contact us for:
Phone: 832-828-1004
Toll free: 1-800-731-8527
Fax: 832-825-8750
Email: providerrelations@texaschildrens.org
Email: providerrelations@texaschildrens.org
Navitus website: www.navitus.com
Navitus toll free provider hotline: 1-877-908-6023
Navitus customer care: 1-866-333-2757
Texas Children's® Link is a web-based provider portal for contracted providers that allows secure, convenient 24-hour access to our member’s information. Through the portal, you can view a Texas Children’s Health Plan member’s eligibility, check the status of your claim, submit an authorization, look up an explanation for CPT, diagnosis, or modifier codes, and more. Click here to learn more.
Password Resets: TCHP strongly encourages you to set up your challenge questions when you first log in to the provider portal. If you forget your password, you’ll be able to reset the password yourself by answering those questions that you’ve previously set up. If your password expires due to non-use for 90 days or you need a password reset, please call TCHP at 832-828-1004. The representative will document needed information for our IS team and then send the information over so your password can be reset within the next 24 to 48 hours.
For a new account: Click here
Only one registration form is necessary per office.
For further assistance, email Provider Relations at ProviderRelations@texaschildrens.org
Please visit our Cultural Competency page to learn more.
DentaQuest (STAR): 1-800-516-0165
DentaQuest (CHIP): 1-800-508-6775
MCNA Dental: 1-800-494-6262
Texas Children’s Health Plan value added benefit:
FCL Dental (STAR members over 21): 1-866-548-8123
Referrals for assistance with chronic, complex conditions, or maternity. Requests for birthing and health education classes.
Phone: 832-828-1430
Fax: 832-825-8745
Asthma / Obesity / Diabetes education:
Phone: 832-828-1004
Fax: 832-825-8705
Nurse-Family Partnership:
Phone: 832-828-1274
Fax: 832-825-8710
Members have access to registered nurses 24 hours a day, 7 days a week.
Texas Children’s Health Plan Nurse Help Line: 1-800-686-3831
Filing deadlines for all products is 95 days from date of service.
Texas Children’s Health Plan Claims
PO Box 300286
Houston, TX 77230-0286
All appeals must be received within 120 days from the previous health plan Explanation of Payment (EOP). Please use the appeal coversheet from Texas Children’s Health Plan Provider Manual.
Texas Children’s Health Plan
Attn: Appeals
PO Box 300286
Houston, TX 77230-0286
Please visit our Prior Authorization Information page for more information.
Patients should be referred to in-network specialists. When Texas Children’s Health Plan members are referred for specialty care to an in-network specialist, it is not necessary to complete a referral form. Members may self-refer for in-network OB/GYN services, behavioral health, family planning, and any Texas Health Steps provider.
It is not necessary to use a referral form for imaging services. Providers should refer members for imaging services.
Providers should refer members for laboratory services to an in network labs or State of Texas Laboratories. Some laboratory services may require prior authorization.
STAR: 800-731-8529
CHIP: 800-731-8528
STAR Kids: 1-844-818-0125