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Medicaid/CHIP

Community participates in the State of Texas Access Reform (STAR) and the Children’s Health Insurance Program (CHIP).

Provider Participation Tools Resources Provider Find

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Health Insurance Marketplace

Community offers health insurance benefits in the Health Insurance Marketplace.

Provider Participation Tools Resources Provider Find

Medicare

Community Health Choice (HMO D-SNP) is a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid.

Resources Provider Find

Adult woman getting her blood pressure checked.

Provider Helpful Links

Texas Medicaid Provider Procedures Manual (TMHP)
Texas Health and Human Services Commission
Texas Medicaid/CHIP Vendor Drug Program
Texas Standard Authorization Form

 

Notice to Physicians and Providers

Community will require all Professional and Institutional claims

Obstetric Delivery Enhanced Claim Requirements for CHIP Perinate Program Claims

Therapy Wait List Announcement for STAR Providers

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.   

Reminder: CHIP-Perinate Coverage of Tdap Vaccine

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


https://hhs.texas.gov/about-hhs/communications-events/news/2017/12/reminder-chip-p-coverage-tdap-vaccine

Obstetric Delivery Enhanced Claim Requirements for CHIP Perinate Program Claims

Obstetric Delivery Enhanced Claim Requirements for CHIP Perinate Program Claims

Beginning January 1, 2019

Community will deny claims for CLIA-waived lab services if Provider does not have a valid CLIA certification

Effective September 1, 2018

For more information visit:
http://www.tmhp.com/News_Items/2018/07-Jul/07-06-18%20Effec%209-1-18,%20Prof-%20Institutional%20Managed%20Care%20Claims%20Must%20Include-Rendering%20Provider%20NPI.pdf

Telemedicine & Telehealth 

Community’s Statement Regarding Cost-Sharing Reductions (CSR)

Ordering, Referring, and Prescribing Providers UPDATE

Medicaid Fraud Notice 10/23/2017

Blue Button

Zika

THSteps Notices from HHSC

THSteps Checkup Documentation

CHIP Notices from HHSC

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.

Community Health Choice, Inc.
Attn: Appeals Department
2636 South Loop West, Suite 125
Houston, TX 77054
Web site: www.communityhealthchoice.org
Fax: 713.295.7033

HHSC Complaints and Appeals e-mail: hpm_Complaints@hhsc.state.tx.us

Stay Connected with Community!

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Provider Services:
Monday - Friday, 8:00 a.m. - 5:00 p.m.
Local 713.295.2295 - Toll-free 1.888.760.2600
Fax: 713.295.2291
E-mail: ProviderRelations@communityhealthchoice.org

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