Effective January 1, 2026, and applicable to all Community First Marketplace plans (University Community Care Plan), a patient’s health plan of record at the date of an inpatient admission is responsible for payment of all covered inpatient facility and professional services until the date the patient is no longer confined to an acute care hospital, regardless of any changes in the patient’s health plan or program enrollment status during the inpatient stay.
The health plan at time of admission is financially responsible for the entire inpatient stay. Providers should seek authorization and submit claims for inpatient services to the health plan that was active at the time of admission.
Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly.
To access all Provider alerts:
- Log into the Community First Provider Portal
- Go to CommunityFirstHealthPlans.com/Provider-News
- Sign up for the Community First Provider eNewsletter