Manuals and forms
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Manuals and forms
Manuals and guides
Downloadable forms
- Behavioral Health Prior Auth Form
- Dell Children’s Health Plan Prior Authorization Form
- Disease Management Referral Form
- Provider payment disputes—file disputes through the provider portal.
- Specialist as Primary Care Provider Request Form
- Texas Health Steps Provider Outreach Referral Form
- Texas Standard Prior Authorization Request Form for Health Care Services
- Texas Standard Prior Authorization Request Form for Prescription Drug Benefits
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
- TRR UM Guidelines – Adult Mental Health Services
- TRR UM Guidelines – Child Adolescent Services
- Claims for Telephone BH Services
- Behavioral Health Discharge Assistance
- All other Behavioral Health Assistance
- Behavioral Health Provider Search
Updating provider information with Dell Children's Health Plan
- If you are an already contracted group but need to add a new provider, you can easily submit the Add a Provider to an Existing Group Contract form to our Provider Relations inbox at shpproviderservices@seton.org.
- If you need to make any changes to a provider’s address, phone number, group affiliation or other updates, please request for our “Additional Changes Roster” spreadsheet by emailing our Provider Relations inbox at shpproviderservices@seton.org.
