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For Providers

Our website for providers is designed as a tool to help you. You can find an array of resources such as:

Provider Manuals

Helpful links

Member Rights and Responsibilities 

Clinical and Administrative Advisory Committee, Behavioral Health Advisory Committee, Perinatal Advisory Committee

These Provider Advisory Groups provide recommendations to Texas Children’s Health Plan in the following areas:

  • Identification and review of clinical practice guidelines and prior authorization guidelines;
  • Review of general utilization patterns and assessment of Provider compliance with clinical guidelines;
  • Recommendations for member engagement and quality improvement programs to improve health outcomes and keep members healthy
  • Strategies and recommendations for improving Health Plan administrative processes;
  • Recommendations on how to improve care based on Member feedback and their personal experiences serving our Members; and
  • Opportunities for connecting network Providers and Managed Care Organization clinical experts for purposes of peer support and sharing best practices.

There is a Clinical and Administrative Advisory Committee for each of our three Service Areas:

  • Harris
  • Jefferson
  • Rural Service Area Northeast

The Behavioral Health Advisory Committee and Perinatal Advisory Committee meet in the Harris Service Area.

The meeting cadence for each of the committees are as follows:

  • Clinical and Administrative Advisory Committee meets 9 times per year in the Harris Service Area and quarterly in the Jefferson and Rural  Service Area Northeast
  • Behavioral Health Advisory Committee meets quarterly
  • Perinatal Advisory Committee meets quarterly