Health Plans
- - - Community First is proud to offer high-quality health care coverage for individuals and families. We believe that everyone deserves access to the services and support needed to live a healthier life. We are proud to have touched the lives of over 3 million individuals since 1995.
      
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About
- - - Community First Health Plans was established in 1995 by University Health specifically to begin providing health care coverage to the citizens of Bexar and it’s seven surrounding counties.
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- - - At Community First, our mission is to not only improve the health outcomes of our Members, but also the overall health of our community. A portion of all Community First’s proceeds goes directly into improving the community we are a part of.
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Category: Provider Resource

Claim Appeal Form

May 31, 2022 | Community First Providers, Provider Resource

Community First Claim Appeal Form (PDF) Providers have the right to appeal the denial of a claim by Community First Health Plans. To file an appeal, Providers should complete the Community First Claim Appeal Form (linked above). Mail the completed form, a copy of...

EVV Visit Maintenance Processes on Hold for Dates of Service Prior to Go-Live Date with Current EVV

Feb 12, 2024 | EVV News, HHSC News, Medicaid Providers, Provider Resource

Program providers, financial management services agencies (FMSAs) and Consumer Direct Services (CDS) employers should not submit Visit Maintenance Unlock Requests (VMURs) for dates of service prior to going live with HHAeXchange or their EVV proprietary system. HHSC...

Availity Single Claims Submission

Jan 26, 2022 | Community First Providers, Provider News, Provider Resource

For Providers who do not have their own clearing house for claims submissions, Community First offers two single-claim submission options at no cost to members of our Provider Network: Availity and Claim MD, both accessible through the Community First Provider Portal....

Covid-19 ECHO Sessions for Providers

Feb 10, 2022 | Community First Providers, Provider Resource

UT Health Confianza is providing COVID-19 Health Literacy ECHO sessions to share up-to-date information about COVID-19 to local providers. ECHO Sessions will include didactics followed by participant presentations of real-life situations and group discussion to share...

Formulary Changes for Commercial and Exchange Plans

May 4, 2022 | Community First Providers, HIE Providers, HMO Providers, Provider Resource

Here are the Formulary changes for Commercial and Exchange plans in April 2022.

External Medical Reviews

Mar 25, 2022 | Community First Providers, Provider Resource

Senate Bill 1207 – External Medical Reviews In accordance with Tex. Gov’t. Code Section 531.024162, as amended by Senate Bill 1207, HHSC is required to contract with an independent review organization (IRO) to perform external medical reviews (EMR) when...