The Claims mailing address is:
Community Health Choice
P.O. Box 301424
Houston, TX 77230
Or you can file electronically: Electronic Payor ID number for Community is 60495.
Clearninghouse: Change Health Care
Or send via certified mail to:
Community Health Choice
2636 South Loop West, Suite 125
Houston, TX 77054
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 180 days from the disposition of a claim to submit a request for reconsideration of a claim or to appeal a decision related to medical necessity.
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 180 days from the disposition of a claim to submit a request for reconsideration of a claim or to appeal a decision related to medical necessity.
Call Community Health Choice Provider Services at 713.295.6704 to ask specific questions about payment and claims issues. Most times they can research and provide answers immediately. If you have further questions or feel you are still in disagreement, you may file a request for reconsideration of a claim within 180 days of receiving the initial EOP.
The mailing address for Claims Payment Reconsiderations is:
Community Health Choice
ATTN: Claims Payment Reconsiderations
2636 South Loop West, Suite 125
Houston, TX 77054
You may also fax requests for reconsiderations to 713.295.7027.
We do not require a referral for you to refer a Member to an in-network specialist. You can confirm a network specialist by checking this website or by calling our Provider Services at 713.295.6704.
You can do the following:
Once your application is received, we will establish your secure access login name and personal identification number (PIN) within three working days.
You can search by using any of these options:
You can:
You can search by using any of these options:
You can search by using either of these options:
The Claims mailing address is:
Community Health Choice
P.O. Box 301404
Houston, TX 77230-1404
Or you can file electronically:
Electronic Payor ID number for Community is 48145
Clearinghouses include:
Availity
Change Healthcare Trizetto
TMHP
Or send via certified mail to:
Community Health Choice
2636 South Loop West, Suite 125
Houston, TX 77054
We follow NHIC guidelines. Refer to the Texas Medicaid Provider Manual for specific filing instructions. You will find it the TMHP website at http://www.tmhp.com/Pages/Medicaid/
Medicaid_Publications_Provider_manual.aspx.
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 120 days from the disposition of a claim to submit a request for reconsideration of a claim or appeal a decision related to medical necessity.
We follow NHIC guidelines. Refer to the Texas Medicaid Provider Manual for specific filing instructions. You will find it in the TMHP website at http://www.tmhp.com/Pages/Medicaid/
Medicaid_Publications_Provider_manual.aspx.
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 120 days from the disposition of a claim to submit a request for reconsideration of a claim or appeal a decision related to medical necessity.
Call Community Health Choice Provider Services at 713.295-.2295 to ask specific questions about payment and claims issues. Most times they can research and provide answers immediately. If you have further questions or feel you are still in disagreement, you may file a request for reconsideration of a claim within 120 days of receiving the initial EOP.
The mailing address for Claims Payment Reconsiderations is:
Community Health Choice
ATTN: Claims Payment Reconsiderations
2636 South Loop West, Suite 125
Houston, TX 77054
You may also fax requests for reconsiderations to 713.295.2291.
At no time can a Provider bill a Community Health Choice Member for a covered service provided. The Medicaid STAR Program does not require any co-payments from STAR Members.
Please visit the Join Community page for more information.
We do not require a referral for you to refer a Member to an in-network specialist. You can confirm a network specialist by checking this website or by calling our Provider Services at 713-295-2295.
Please call Provider Services to see if we are in the process of contracting with the hospital. In addition, Medical Affairs may be able to authorize out-of-network hospitals if an in-network hospital is not located nearby and if you are unable to manage the Member’s care at an in-network facility. Medical Affairs and Provider Services will work with you and hospitals to ensure optimum treatment for our Members.
Community most frequently pays 100% of then current Medicaid Allowable for Medicaid covered benefit codes. Variance may occur according to contract.
According to Medicaid rules and Community guidelines, Members may access THSteps services from any willing THSteps Provider. We request out-of-network Providers call to confirm Member eligibility and to confirm information for claims payment. Community will pay 100% of then current Medicaid Allowable to any THSteps Provider who fulfills THSteps services to a Member within the correct eligibility guidelines.
Community offers value-added benefits for Members including care management programs, access to health education, vision and dental benefits, a 24-hour Nurse Advice Line, and more. Please call Community for more information.
A Provider may file a complaint with Community at any time.
Submit complaints to:
Community Health Choice
Attn: Service Improvement
2636 South Loop West, Suite 125
Houston, TX 77054
Fax: 713.295.7036
Email: [email protected]
Community shall acknowledge all oral and written complaints within five business days. Community shall acknowledge, investigate and resolve all complaints no later than the 30th calendar day after the date Community receives the oral or written complaint.
After a Provider has exhausted the appeal process with Community, a Provider has the right to file a complaint with HHSC.
Send Provider appeals to HHSC to:
Texas Health and Human Services Commission
Re: Provider Complaint Health Plan Operations, H-320
P.O. Box 85200
Austin, TX 78708
Email: [email protected]
You can do the following:
Once your application is received, we will establish your secure access login name and personal identification number (PIN) within three working days.
You can search by using any of these options:
You can:
You can search by using any of these options:
You can search by using either of these options:
The Claims mailing address is:
Community Health Choice
P.O. Box 301424
Houston, TX 77230
Or you can file electronically: Electronic Payor ID number for Community is 60495.
Clearninghouse:
Change Health Care
Or send via certified mail to:
Community Health Choice
2636 South Loop West, Suite 125
Houston, TX 77054
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 180 days from the disposition of a claim to submit a request for reconsideration of a claim or to appeal a decision related to medical necessity.
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 180 days from the disposition of a claim to submit a request for reconsideration of a claim or to appeal a decision related to medical necessity.
Call Community Health Choice Provider Services at 713.295.6704 to ask specific questions about payment and claims issues. Most times they can research and provide answers immediately. If you have further questions or feel you are still in disagreement, you may file a request for reconsideration of a claim within 180 days of receiving the initial EOP.
The mailing address for Claims Payment Reconsiderations is:
Community Health Choice
ATTN: Claims Payment Reconsiderations
2636 S. Loop West, Suite 125
Houston, TX 77054
You may also fax requests for reconsiderations to 713.295.7027.
We do not require a referral for you to refer a Member to an in-network specialist. You can confirm a network specialist by checking this website or by calling our Provider Services at 713-295-6704.
The Claims mailing address is:
Community Health Choice
P.O. Box 301424
Houston, TX 77230
Or you can file electronically: Electronic Payor ID number for Community is 60495.
Clearninghouse:
Change Health Care
Or send via certified mail to:
Community Health Choice
2636 South Loop West, Suite 125
Houston, TX 77054
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 180 days from the disposition of a claim to submit a request for reconsideration of a claim or to appeal a decision related to medical necessity.
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 180 days from the disposition of a claim to submit a request for reconsideration of a claim or to appeal a decision related to medical necessity.
Call Community Health Choice Provider Services at 713.295.6704 to ask specific questions about payment and claims issues. Most times they can research and provide answers immediately. If you have further questions or feel you are still in disagreement, you may file a request for reconsideration of a claim within 180 days of receiving the initial EOP.
The mailing address for Claims Payment Reconsiderations is:
Community Health Choice
ATTN: Claims Payment Reconsiderations
2636 S. Loop West, Suite 125
Houston, TX 77054
You may also fax requests for reconsiderations to 713.295.7027
We do not require a referral for you to refer a Member to an in-network specialist. You can confirm a network specialist by checking this website or by calling our Provider Services at 713.295.6704.
You can do the following:
Once your application is received, we will establish your secure access login name and personal identification number (PIN) within three working days.
You can search by using any of these options:
You can:
You can search by using any of these options:
You can search by using either of these options:
The Claims mailing address is:
Community Health Choice
P.O. Box 301424
Houston, TX 77230
Or you can file electronically: Electronic Payor ID number for Community is 60495.
Clearninghouse:
Change Health Care
Or send via certified mail to:
Community Health Choice
2636 South Loop West, Suite 125
Houston, TX 77054
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 180 days from the disposition of a claim to submit a request for reconsideration of a claim or to appeal a decision related to medical necessity.
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 180 days from the disposition of a claim to submit a request for reconsideration of a claim or to appeal a decision related to medical necessity.
Call Community Health Choice Provider Services at 713-295-6704 to ask specific questions about payment and claims issues. Most times they can research and provide answers immediately. If you have further questions or feel you are still in disagreement, you may file a request for reconsideration of a claim within 180 days of receiving the initial EOP.
The mailing address for Claims Payment Reconsiderations is:
Community Health Choice
ATTN: Claims Payment Reconsiderations
2636 South Loop West, Suite 125
Houston, TX 77054
You may also fax requests for reconsiderations to 713.295.7027
We do not require a referral for you to refer a Member to an in-network specialist. You can confirm a network specialist by checking this website or by calling our Provider Services at 713-295-6704.
You can do the following:
Once your application is received, we will establish your secure access login name and personal identification number (PIN) within three working days.
You can search by using any of these options:
You can:
You can search by using any of these options:
You can search by using either of these options:
The Claims mailing address is:
Community Health Choice
P.O. Box 301404
Houston, TX 77230-1404
Or you can file electronically:
Electronic Payor ID number for Community is 48145
Clearinghouses include:
Availity
Change Healthcare Trizetto
TMHP
Or send via certified mail to:
Community Health Choice
2636 South Loop West, Suite 125
Houston, TX 77054
We follow NHIC guidelines. Refer to the Texas Medicaid Provider Manual for specific filing instructions. You will find it the TMHP website at http://www.tmhp.com/Pages/Medicaid/Medicaid_Publications_Provider_manual.aspx.
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 120 days from the disposition of a claim to submit a request for reconsideration of a claim or appeal a decision related to medical necessity.
We follow NHIC guidelines. Refer to the Texas Medicaid Provider Manual for specific filing instructions. You will find it in the TMHP website at http://www.tmhp.com/Pages/Medicaid/Medicaid_Publications_Provider_manual.aspx.
The deadline for filing Clean Claims is 95 days from the date of service.
The Provider has 120 days from the disposition of a claim to submit a request for reconsideration of a claim or appeal a decision related to medical necessity.
Call Community Health Choice Provider Services at 713.295.2295 to ask specific questions about payment and claims issues. Most times they can research and provide answers immediately. If you have further questions or feel you are still in disagreement, you may file a request for reconsideration of a claim within 120 days of receiving the initial EOP.
The mailing address for Claims Payment Reconsiderations is:
Community Health Choice
ATTN: Claims Payment Reconsiderations
2636 South Loop West, Suite 125
Houston, TX 77054
You may also fax requests for reconsiderations to 713.295.2291.
At no time can a Provider bill a Community Health Choice Member for a covered service provided. The Medicaid STAR Program does not require any co-payments from STAR Members.
We do not require a referral for you to refer a Member to an in-network specialist. You can confirm a network specialist by checking this website or by calling our Provider Services at 713.295.2295
Please call Provider Services to see if we are in the process of contracting with the hospital. In addition, Medical Affairs may be able to authorize out-of-network hospitals if an in-network hospital is not located nearby and if you are unable to manage the Member’s care at an in-network facility. Medical Affairs and Provider Services will work with you and hospitals to ensure optimum treatment for our Members.
Community most frequently pays 100% of then current Medicaid Allowable for Medicaid covered benefit codes. Variance may occur according to contract.
According to Medicaid rules and Community guidelines, Members may access THSteps services from any willing THSteps Provider. We request out-of-network Providers call to confirm Member eligibility and to confirm information for claims payment. Community will pay 100% of then current Medicaid Allowable to any THSteps Provider who fulfills THSteps services to a Member within the correct eligibility guidelines.
Community offers value-added benefits for Members including care management programs, access to health education, vision and dental benefits, a 24-hour Nurse Advice Line, and more. Please call Community for more information.
A Provider may file a complaint with Community at any time.
Submit complaints to:
Community Health Choice
Attn: Service Improvement
2636 South Loop West, Suite 125
Houston, TX 77054
Fax: 713.295.7036
Email: [email protected]
Community shall acknowledge all oral and written complaints within five business days. Community shall acknowledge, investigate and resolve all complaints no later than the 30th calendar day after the date Community receives the oral or written complaint.
After a Provider has exhausted the appeal process with Community, a Provider has the right to file a complaint with HHSC.
Send Provider appeals to HHSC to:
Texas Health and Human Services Commission
Re: Provider Complaint Health Plan Operations, H-320
P.O. Box 85200
Austin, TX 78708
Email: [email protected]
You can do the following:
Once your application is received, we will establish your secure access login name and personal identification number (PIN) within three working days.
You can search by using any of these options:
You can:
You can search by using any of these options:
You can search by using either of these options:
Community Health Choice is one of the greatest companies that I know. This program gives me hope in our Community.
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