Update: Community has extended the deadline for submission of the CHIP Co-Pays that were waived as a result of Harvey.

  • The previous deadline was 95 days from November 30, 2017, which was March 5, 2018.
  • The new deadline is May 31, 2018. 
  • Please be sure to follow the process detailed below.

Update regarding CHIP Co-payments Waiver - Community Health Choice will be reimbursing providers who rendered services to Community Health Choice CHIP members and did not collect a co-pay between Aug. 25 and Nov. 30, 2017. In order for providers to be reimbursed for CHIP co-pays for CHIP members living or displaced from a Hurricane Harvey FEMA-declared disaster county, the following must occur:

  • Providers must sign the attached attestation form
  • Providers must prepare an invoice detailing Community Health Choice members who were seen during this time period.
    • Invoice must include Member name, Community Health Choice Member ID, date of service, co-pay amount (not collected), and description of services provided
  • Attestation and invoice should be sent to:
    Community Health Choice
    Attention: Finance
    2636 South Loop West, Suite 125
    Houston, TX 77054
  • Providers have 95 days from Nov. 30, 2017, to submit this information for payment. It is important that all necessary information be provided in order to be reimbursed for services. If the information provided is incomplete, payment will not be made.

If you have any questions regarding this process, please contact Provider Relations at ProviderRelationsInquiries@CommunityHealthChoice.org


 


 

 

  • Hurricane Harvey Information for Providers - On Aug. 25, 2017, Hurricane Harvey hit the Texas coast and caused significant damage and flooding in numerous counties forcing many to evacuate to temporary locations. Texas Health and Human Services is committed to sharing pertinent Hurricane Harvey information with you. The links and information below will help our providers and other stakeholders get services to those in need during this emergency situation. Go to the Web site: https://hhs.texas.gov/services/health/medicaid-chip/provider-information/hurricane-harvey-information-providers

     

  • Hurricane Harvey Delay: Provider Enrollment Requirement for Ordering, Referring & Prescribing - Due to the impact of Hurricane Harvey and pending decisions that may impact the implementation of the Federal Regulation, HHSC is delaying the deployment of 42 CFR 455.410, which required all Ordering, Referring or Prescribing (ORP) providers to be enrolled as participating providers in Medicaid (this included prescription drugs dispensed at a pharmacy). All medical and pharmacy claims will continue to pay through calendar year 2017 regardless of the ORP provider's Texas Medicaid enrollment status. Effective January 1, 2018, HHSC will begin enforcing the ORP enrollment requirement for Medicaid, Children's Health Insurance Program (CHIP), Healthy Texas Women (HTW) program, and Children with Special Health Care Needs (CSHCN) program. HHSC will provide specific dates and details in the coming weeks. If possible, ORP providers should still begin the enrollment process before January by completing the application online at http://www.tmhp.com/Pages/ProviderEnrollment/PE_TX_Medicaid_New.aspx. For more information, call the TMHP Contact Center at 1.800.925.9126 or the TMHP-CSHCN Services Program Contact Center at 1.800.568.2413.

 

Out-of-Network Service for Members Affected by Hurricane Harvey - Community understands that many of our Members have been affected by Hurricane Harvey. Members who displaced due to Hurricane Harvey and have an urgent need to see a doctor may go to the nearest medical care. In this special situation, Members do not need to get prior authorization to see an out-of-network doctor for urgent care. If the Member’s medical need is not urgent, or he/she was not displaced by Hurricane Harvey, they should get care from an in-network doctor. If you do see a Community Health Choice Member on an out-of-network basis, please contact us to let us know the circumstances, including the clinical reason.