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...
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...
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....
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...
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...