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Texas Children's Health Plan

Part of Texas Children's Hospital

Medicaid managed caremedical
Typical enrollment turnaround
60-90 days

Summary

Texas Children's Health Plan is a Medicaid managed care organization, part of Texas Children's Hospital, offering medical coverage operating in Texas. Claims route under payer ID 75228, with 5 alternate IDs in use across clearinghouses. Provider enrollment typically takes 60-90 days, with applications through TX Children's Provider Portal, and CAQH is used for credentialing data. Through clearinghouses it supports eligibility checks, professional claims, and institutional claims.

At a glance

Payer ID
75228Also seen as 14372, 1911, 2483, 75228MC, TXCSM
Also known as
Texas Children's Health Plan (Medicaid) STAR & STAR Kids, Texas Children's Hospital, Texas Childrens Health Plan (Star Medicaid / Medicaid Managed Care)
Uses CAQH
YesApplication route: Payer portal application
Service area
TX (Houston area)

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

TransactionEnrollmentTypical setup
Eligibility checks (270/271)Not requiredImmediate
Professional claims (837P)Not requiredImmediate
Institutional claims (837I)Not requiredImmediate

Common questions

What is the payer ID for Texas Children's Health Plan?
The payer ID for Texas Children's Health Plan is 75228. Alternate IDs seen across clearinghouses include 14372, 1911, 2483, 75228MC.
How long does Texas Children's Health Plan provider enrollment take?
Texas Children's Health Plan provider enrollment typically takes 60-90 days from application to effective date. Timelines vary by state, plan, and how complete the application is.
Does Texas Children's Health Plan require CAQH?
Yes. Texas Children's Health Plan uses CAQH for credentialing data, so keep the provider's CAQH profile current and attested before applying.
What states does Texas Children's Health Plan cover?
Texas Children's Health Plan operates in TX (Houston area). Coverage can differ by plan and product line, so confirm the specific plan before you file.
What types of coverage does Texas Children's Health Plan offer?
Texas Children's Health Plan covers medical.

Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.