Claims and Reimbursement
Manuals and Guides
- Medicaid/CHIP Provider Manual
- CHIP & STAR Quick Reference Guide
- CHIP Perinate Quick Reference Guide
- CHIP Provider Directory
- CHIP Perinatal Provider Directory
- STAR Provider Directory
Training
- Behavioral Health Interactive Care Reviewer Training Presentation
- Caring for Diverse Populations Toolkit
- CMS Toolkit – Telehealth for Providers: What You Need to Know
- Cultural Competency Training
- Dell Children’s Health Plan/Amerigroup Partnership Training
- Eligibility & Panel Listing Guide
- External Medical Review (EMR) Provider Training
- External medical review provider training
- HEDIS Benchmarks and Coding Guidelines
- HEDIS Desktop Reference Guide
- Interactive Care Reviewer (ICR) FAQ
- Online Claim Appeal
- Precert Request Tutorial
- Precert Status Appeal
- Provider Digital Engagement
- Provider Secure Site Guide
- PSS Lite Secure Site Guide
- Remit Inquiry Process Guide
- Remit Viewer
- SBIRT Provider Training and Education
- SBIRT Quick Reference Guide – Knowledge Saves – SBIRT Improving Lives Flier
- Why SBIRT Matters? – SBIRT in Action Brochure
Downloadable Forms
- Coordination of Care/Treatment Summary Form
- DCHP Bike Safety Helmet Form
- DCHP Booster Seat Form
- Dell Children’s Health Plan Prior Authorization Form
- Dell Children’s Health Plan Therapy Request Form
- Disease Management Referral Form
- Maternity Notification Form
- Non-emergency Ambulance Exception Form
- Non-emergency Ambulance Prior Authorization Request Form
- Overpayment Refund Notification Form
- PCP Change Form
- PCP Change Form (Spanish)
- Provider Data Update Form
- Provider Payment Dispute and Claim Correspondence Submission Form
- Specialist as Primary Care Provider Request Form
- Special Medical Prior Authorization (SMPA) Request Form
- Texas CCP Prior Authorization Request Form and Instructions
- Texas Health Steps Provider Outreach Referral Form
- Texas Medicaid Physical, Occupational, or Speech Therapy (PT, OT, ST) Prior Authorization Form
- Texas Standard Prior Authorization Request Form for Health Care Services
- Texas Standard Prior Authorization Request Form for Prescription Drug Benefits
- Treatment Plan Request Form for Autism Spectrum Disorders
Behavioral Health
- Behavioral Health Initial Review Form for Inpatient, Residential Treatment Center, Partial Hospital Program and Intensive Outpatient Program
- Behavioral Health Concurrent Review Form for Inpatient, Residential Treatment Center, Partial Hospital Program and Intensive Outpatient Program
- Ambulance Services
- Interactive Care Reviewer Benefits Brochure
- NEMT
- Primary Care NAS NOWS Provider Toolkit
- Rehabilitation Services
- Request for Authorization: Psychological Testing
- Request for Authorization: Neuropsychological Testing
- Screening, Brief Intervention and Referral to Treatment (SBIRT) Flier
- Screening for alcohol use disorder in high-prevalence demographics
- TRR UM Guidelines – Adult Mental Health Services
- TRR-UM Guidelines – Child Adolescent Services
- University of Maryland School of Social Work Texas Center
- Claims for Telephone BH Services
- Behavioral Health Discharge Note
Provider Advisory Group
- Dell Children’s Health Plan invites you to participate in our Provider Advisory Group. If you would like more information on how to get involved and what participating in this group entails, please contact us at Provider Services