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Provider Resources

Provider Resources

Resource Center for Community Providers​

Here in our resource center, Providers have quick access to notifications, processes, forms, and reference guides for all Community Health Choice plans. See below for an overview of what you can find in each section of this Resource Center.

Register here to access the Provider Portal.

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Ready to join our Provider Community?

How to Become a Participating Provider

Application Process

  1. Complete the applicable profile form below to request participation in Community’s programs.
  2. If you are currently part of an IPA, please contact them to determine if they currently have an agreement in place with Community. 
  3. If you have any questions, please contact Provider Services at 713.295.2295 or toll-free at 1.888.760.2600.

Credentialing & Recredentialing Process

As a Medicaid managed care organization, Community Health Choice must utilize the Texas Association of Health Plans’ (TAHP) contracted Credentialing Verification Organization (CVO) as part of its credentialing and recredentialing process regardless of membership in the TAHP. The CVO is responsible for receiving completed applications, attestations and primary source verification documents. At least once every three years, Community Health Choice must review and approve the credentials of all participating licensed and unlicensed Providers who participate in the network.

Upon determination by Verisyi (CVO) that your application is complete, the credentialing process can take up to 90 days.

If you are part of a group that already participates with Community Health Choice, you can request expedited credentialing, which will allow you to serve Medicaid recipients on a provisional basis while your credentialing application is pending. To qualify for expedited credentialing per Sec. 1452 of the Texas Insurance Code, you must meet all of the following criteria:

• Be a member of an established healthcare provider group that has a current contract in force with Community

• Be a provider type specified in TIC 1452

• Be licensed by the State of Texas, and in good standing with the appropriate state licensing Board

• Agree to comply with the terms of the contract

• Submit all documentation and information required to begin the credentialing process

Important:  Please ensure that your credentials and information are current with CAQH to avoid any delays in the credentialing or recredentialing process

Perinatal Transmission of HIV

The Perinatal HIV hotline provides immediate advice on HIV management in pregnant women and their infants, including referral to care.

Perinatal HIV Hotline
https://nccc.ucsf.edu
(888) 448-8765
24 hours, seven days a week

Why Choose Community?

As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family.

“Community Health Choice is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.”

– Cecily
Member of Community Health Choice