As a Dell Children’s Health Plan provider, we value your role in providing quality healthcare to your patients, our members. Our role as a health plan is to provide you with the tools and resources you need to be successful.
If you cannot find what you need here on our website, please contact our Provider Services Hotline at 1-844-781-2343. You may also contact our Provider Engagement Department by email at shpproviderservices@seton.org.
As a provider, you may also access our Provider portal to submit or check status of authorizations, submit or check status of claims and check eligibility for our members by going to https://secure.healthx.com/Provider_2022
Important Links
- Appointment Availability Standards
- Members Rights and Responsibilities
- Texas Medicaid & Healthcare Partnership (TMHP)
- Texas Health and Human Services Commission
- Texas Medicaid/CHIP Vendor Drug Program
Prior Authorizations
- Pharmacy Authorizations
- Behavioral Health Prior Authorizations: magellanhealth.com
- Prior Authorization Forms for all other services
- Prior Authorization Requirements
- Medicaid and CHIP Prior Authorization List
- Prior Authorization Annual Review Report SFY2021
Pharmacy
- Navitus Health Solutions
- Navitus MAC Pricing
- Texas Medicaid/CHIP Vendor Drug Program – Formulary Information
- Texas Medicaid/CHIP Vendor Drug Program – Preferred Drugs
- Texas Vendor Drug Program – Clinical Prior Authorization Criteria
Provider Notices and Reminders
HHSC Notifications
To Providers: Please update your enrollment and demographic information with TMHP (Texas Medicaid Healthcare Partnership). TMHP is HHSC’s provider enrollment administrator and serves as the authoritative source for HHSC Providers’ enrollment and demographic information. Once you update your enrollment and demographic information with TMHP, your data will be reconciled with the demographic information on file with the MCOs. To make updates to your current enrollment (e.g., new practice locations or change of ownership updates), please access the web page titled “Provider Enrollment on the Portal – A Step-by-Step Guide”.
For instructions on how to make other demographic updates to your current enrollment, please access the document titled “Provider Information Management System (PIMS) User Guide”.
Otherwise, you can contact TMHP directly at 1-800-925-9126 for assistance.