Prior Authorization Information | Texas Children's Health Plan
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Prior Authorization Information

Authorizations

 

Prior Authorization Fax Lines

  • Medical Services Fax Line - 832-825-8760 or Toll-Free 1-844-473-6860
  • Behavioral Health Services Fax Line - 832-825-8767 or Toll-Free 1-844-291-7505
  • LTSS and Private duty Nursing Fax Line - 346-232-4757 or Toll-Free 1-844-248-1567

Contact Us

Please contact us if you have questions or need assistance with prior authorizations.
 
Providers: 1-800-731-8527
 
Providers may also reach out to their Provider Relations Liaison, contact information is available here.
 
Members:
 
  • CHIP 1-866-959-6555
  • STAR 1-866-959-2555
  • STAR Kids 1-800-659-5764
Texas Children’s Health Plan offers TDD.TTY services for deaf, hard of hearing or speech impaired members and providers. For TDD assistance, please call 1-800-735-2989 or 7-1-1.

Prior Authorization Determinations

The Utilization Management department processes service requests in accordance with the clinical immediacy of the requested services.

Authorization | Turnaround Time
Routine Within 3 business days after receipt of request
Urgent Within 1 business day after receipt of request
Inpatient Within 1 business day after receipt of request

Prior Authorization Guidelines

Below you will find all of the Prior Authorization Guidelines. If you wish to open the following forms, you must have Adobe Acrobat Reader installed on your computer. To download a form, right click on one of the links below and select "Save Target As."
 
Providers should reference the guidelines listed below for a specific service. Each guideline lists the required documentation and forms that must accompany an authorization request.
 
Download a free copy of Adobe Acrobat Reader, click here.