Automated Prior Authorization Process!
Transition to Interqual Criteria effective September 1, 2019
Behavioral Health transitions to Community, effective September 1, 2019
for all STAR, CHIP, CHIP-P and Marketplace
Annual Mandatory Texas Health Steps Provider Training
Join the COMMUNITY network to access your account.
Medicaid/CHIP
Community participates in the State of Texas Access Reform (STAR) and the Children’s Health Insurance Program (CHIP)!
Health Insurance Marketplace
Community now offers health insurance benefits in the Health Insurance Marketplace!
Community will require all Professional and Institutional claims
Therapy Wait List Announcement for STAR Providers
Zika Mosquito Repellent Benefit Notices
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
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
Ordering, Referring, and Prescribing Providers UPDATE
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
Community’s Statement Regarding Cost-Sharing Reductions (CSR)
NOTICE TO PHYSICIANS AND PROVIDERS
Ordering, Referring, and Prescribing Providers UPDATE
Medicaid Fraud Notice 10/23/2017
Zika
THSteps Notices from HHSC
THSteps Checkup Documentation
CHIP Notices from HHSC
Infant Botulism Alert
Preventing Lead Exposure - an online course
WIC and Postpartum Depression Resources
Prenatal Screening for Domestic Violence and Substance Use
Medicaid Fraud Notice 10/23/2017
CHIP Provider Enrollment Webinar
Hurricane Harvey
- Hurricane Harvey Information for Providers
- Hurricane Harvey Delay: Provider Enrollment Requirement for Ordering, Referring & Prescribing
- CHIP Co-payments Waiver August 25, 2017 through November 30, 2017
THSteps Notices from HHSC
- Provider Letter Texas Health Steps Documentation Improvement
- Texas Health Steps Clinical Record Review Tool with Instructions
- Texas Health Steps Clinical Record Review Tool
- Texas Health Steps Regional Contacts
- Texas Health Steps Regional Provider Representatives
- Postpartum Depression Screening
- Texas Health Steps Mental Health Screening Change for 12 to 18 Year Olds
Zika Mosquito Repellent Benefit Notices
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