Jun 11, 2026 | Provider Resource
Community First Health Plans (Community First) would like to remind providers of the billing requirements for inpatient claims totaling $10 million or more. To ensure proper claims processing, these claims must be split into multiple submissions, with each interim...
Jun 8, 2026 | Provider News, Provider Resource
Purpose This billing guide outlines the appropriate use of Modifier 25 when reporting evaluation and management (E/M) services performed on the same date as a preventive medical checkup. Policy Overview Providers may be reimbursed for both a preventive checkup and an...
Jun 8, 2026 | Provider News, Provider Resource
This notice provides guidance on the appropriate use of Modifier 26 (Professional Component) when billing for diagnostic services, consistent with CMS billing principles. Overview Some CPT codes represent services that include two distinct parts: A professional...
May 28, 2026 | HHSC News, Provider News, Provider Resource
Community First Health Plans is sharing information regarding TMHP’s implementation of a new login platform, TMHP IAMOnline, which will serve as the single sign‑on entry point for Texas Medicaid Provider portal applications. What Providers Need to Do: Follow the...
May 27, 2026 | Provider News, Provider Resource
As a participating Provider with Community First Health Plans, it is crucial to adhere to our policies regarding Member billing. This notice serves as a reminder of your obligations and our Members’ rights, particularly concerning balance billing practices....
Apr 13, 2026 | Provider News, Provider Resource
The information below outlines Community First Health Plans, Inc. and Community First Insurance Plans (Community First) requirements for identifying, applying, and maintaining preauthorization exemptions, including correct claim submission procedures and documentation...
