Mar 25, 2022 | Community First Providers
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...
May 26, 2022 | EVV News, Medicaid, Medicaid Providers, Providers
There will be revisions to the Electronic Visit Verification (EVV) Policy Handbook, these revisions will publish and be effective June 1, 2022. The handbook includes EVV standards and policy requirements for: Program ProvidersFinancial Management Services Agencies...
May 26, 2022 | Medicaid, Medicaid Providers, Providers
Community First will not be requiring authorization for behavioral health services that are managed by and billed by the patient’s PCP. This is part of the Collaborative Care Model (CoCM). Senate Bill 672, 87th Legislature, Regular Session, 2021 directed HHSC to...
May 26, 2022 | EVV News, Medicaid, Providers
Payers will begin conducting Electronic Visit Verification Usage Reviews for Consumer Directed Services employers for dates of service on and after September 1, 2022. Beginning September 1, 2022, payers will review the EVV Usage Score for CDS employers. The notice...
May 24, 2022 | EVV News, Medicaid, Providers
On March 28, HHSC requested feedback from MCOs about updating the Electronic Visit Verification (EVV) Visit Maintenance Unlock Request (VMUR) templates. HHSC processed the feedback received from TMHP, EVV vendors and MCOs and decided to add a new option to the...
Mar 1, 2019 | Provider News
Community First Health Plans has partnered with Payspan to provide claim reimbursement and remittance advice (EOP) for our Providers. This free service electronically deposits Community First Health Plans provider reimbursement payments to the bank account(s) of your...
Feb 22, 2021 | Medicaid News
How can Community First Health Plans serve you better? How can we help you choose the best health care plan for you and your family? Community First is continuously working to improve our delivery of quality care and service in a safe manner. To reach this goal, we...
Mar 21, 2022 | Community First Providers
Community First is committed to providing ongoing information as we move towards the implementation of new Claims Editing Software (CES). On April 1, 2022, Community First will implement a claims pre-payment auditing process that identifies frequent correct coding...
May 10, 2022 | Community First Providers
Your Patients’ Medicaid Coverage May Be Impacted by the End of the COVID-19 Public Health Emergency Continuous Medicaid Coverage May End Soon Your patients’ Medicaid coverage may be impacted by the end of the COVID-19 federal public health emergency (PHE). Medicaid...
May 11, 2022 | Press Release
SAN ANTONIO, TX (May 10, 2022) – Community First Health Plans, Inc. has begun efforts to communicate with its Members about renewing their Medicaid and CHIP coverage in preparation for the end of the COVID-19 pandemic public health emergency (PHE). Since March...
