Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ...
Background:MCOs were notified in the Aug. 12 MCO Notice that HHSC requested to delay the Jan. 1, 2020 EVV start date for the programs, services, and service delivery options affected by the 21st Century Cures Act.Key Details: The Centers for Medicare and Medicaid...
Effective June 1, 2019, Community First Health Plans (CFHP) implemented a new core claim processing platform called QNXT. To facilitate data transfer to the new system, all active Members in the legacy system, Amisys, were terminated on May 31, 2019. Upon transfer,...
Effective October 15, 2019, CFHP will require Providers to use a physical address when submitting claims. Due to HHSC requirements, the use of P.O. Box addresses will not be allowed as a billing address.If you have questions regarding this communication update, please...
CFHP has resolved the issue with the response files known as 277CA and 999, which alert a claim submitter as to the “Acceptance” or “Rejection” of a claim submission. The 277CA and 999 files are now being posted to the CFHP Claim Clearinghouses and all files dating...
Dear Participating Provider,Effective June 1, 2019, Community First health Plans (CFHP) implemented a new core claim processing platform called QNXT. Electronic or Paper claims submitted on or after June 1, 2019 to CFHP should be submitted using the Medicaid...