Automated Prior Authorization Process!
Community participates in the State of Texas Access Reform (STAR) and the Children’s Health Insurance Program (CHIP)!
Community now offers health insurance benefits in the Health Insurance Marketplace!
Attention STAR Therapy Providers-Community Health Choice has launched the Provider Therapy Wait List Form via our Provider Portal for STAR Physical Therapy, Speech Therapy and Occupational Therapy wait lists. Please see the attached document for more information and step-by-step instructions on how to notify Community if you experience a Therapy Provider wait list.
The Tetanus, Diphtheria, and Acellular Pertussis (Tdap) vaccine is part of routine prenatal care and is a covered benefit in CHIP-P.
This vaccine is recommended by the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), and American College of Obstetricians and Gynecologists (ACOG) as part of routine prenatal care:
• CDC: https://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html
• AAP: https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Updates-TDAP-Recommendations.aspx
• ACOG: https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Update-on-Immunization-and-Pregnancy-Tetanus-Diphtheria-and-Pertussis-Vaccination
Community will deny claims for CLIA-waived lab services if Provider does not have a valid CLIA certification
Effective January 15, 2018, TMHP and the Vendor Drug Program requires all Providers who Order, Refer and Prescribe for traditional FFS Medicaid, Children with Special Healthcare Needs Services Program, or Healthy Texas Women Members to be in enrolled in the Texas Medicaid program. While HHSC has allowed for a three month grace period from January 15 to April 16, 2018 for Providers to complete their enrollment process, it is critical that this be done as soon as possible.
More about these requirements: http://www.tmhp.com/TMHP_File_Library/FAQ/ORP_Providers_FAQs.pdf
Please log in to your account to access. It is under Provider Tools > Policies & Guidelines.
Please log in to your account to access. It is under Provider Tools > Authorization/Notifications.
Share your e-mail address to stay up to date on Provider news, events and offerings.
Monday - Friday, 8:00 a.m. - 5:00 p.m.
Local 713.295.2295 - Toll-free 1.888.760.2600