Member ID Number. Our Customer Service Representatives will be happy to help you by phone at the numbers above. Paper using a CMS 1500 or UB04. Click here to learn more. For support, please contact our EDI Department at 1-800-225-2573, ext. Find out More. DOES NOT meet the criteria for any other type of Medicaid coverage, they will continue in their same type of Medicaid coverage until the federally-declared public health emergency ends or federal guidance changes. Phone number: 1-888-345-2619; TTY users, please call 711. Business hours are 7 AM 10 PMfrom Monday Friday and 7 AM 7 PM on Saturday and Sunday. Place of Service. The National Committee for Quality Assurance (NCQA) awarded FirstCare Health Plans an Accredited Status (Commercial, Medicaid, Marketplace HMO, recertified 03/2021) - reflecting our continuous work to fulfill NCQA requirements for consumer protection & quality improvement. they will move you to the appropriate type of Medicaid coverage based on the eligibility criteria your household meets. Medicaid members who have renewals due during the pandemic will receive a notice from HHSC on next steps to take to maintain their Medicaid coverage after the pandemic ends. Marketplace, Medicaid, and CHIP plans to fit your life. Clients who voluntarily leave/withdraw from Medicaid. In Virginia, CareFirst MedPlus and CareFirst Diversified Benefits are is the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). In fact, we were born and bred right here in the Lone Star State. Provider: 866-773-0404. Learn more about CareFirsts NPI requirement for claims submission. In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. Contact Information. Complete our simple feedback form or email us. Managed Care hours of operations are 8 a.m. - 6 p.m. Central Time, Monday through Friday. Mail paper claims to: CareFirst Community Health Plan Maryland. As part of the CMS Hospital Without Walls initiative, hospitals can provide hospital services in other healthcare facilities and sites not currently considered to be part of a healthcare facility or set up temporary expansion sites to help address the urgent need to increase capacity to care for patients, in response to the COVID-19 pandemic. Firstcare Of America, Inc. is a Delaware Corporation filed On May 13, 1983. If you want to remain on these pages, click Cancel or close this box. We offer a holistic solution that ensures early interventions, swift referrals to physical and mental health services, and safe, timely returns to work. Non-Emergency Medical Transportation Services, https://hhs.texas.gov/about-hhs/your-rights/hhs-office-ombudsman. If you are looking to buy or renew a CareFirst plan, please contact us at 800-544-8703. FirstCare ProvidersFirstCare.com/Providers Customer Service Department (Member Eligibility and Benefit Questions) HMO 1-800-884-4901 PPO 1-800-240-3270 Claims Claims Mailing Address (Please use this address for all claim-related correspondence including original claim submissions, adjustment requests and recovery correspondence). United Healthcare. Do not send duplicate copies of information. Were owned by Texas-based Baylor Scott & White Health Planpart of Baylor Scott & White Healthand today, we serve nearly 400,000 members in 171 counties throughout west and central Texas, including areas underserved by other health plans. or 840 First St., NE in Washington, D.C. Plan Information. Address. Were always looking for exceptional providers to join our growing network of physicians and hospitals. Review of Inpatient Claims for Spell-of-Illness Limitation. 25525, or visit our website at. While others just count the cost of absence, GoodShape addresses the root causes. Write to: Texas Health and Human Services Commission Office of the Ombudsman, MC H-700 P.O. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. The website contains our electronic Billing Manual which offers detailed information regarding claims billing instructions, requirements for the CMS 1500/837 Professional, and the UB04/837 facility claim forms. July 2020 Preferred Drug List Revised September 8, 2020 . Call 844.633.5325* | TTY: 711(7 AM-7 PM CT, weekdays) Fax: 254.298.3385 Non-member: 866.522.2515 | TTY: 711 If you are a FirstCare Health Plans Marketplace member in West Texas, visit FirstCare.com. If you need further assistance from Availity, please contact Client Services at (800) 282-4548 Registration Get secure, instant access to your coverage anytime by logging in to the Hally app or at login.firstcarolinacare.com. Looking for data, analyses or commentary about workplace wellbeing and performance? If you need further assistance, HHSC Managed Care can assist. Please ensure recipient email address is valid. If HHSC receives information that your household has a change in circumstances (such as income, expenses, people in the household, etc.) Suggest a topic for the CPET Learning Library. 2022 Scott and White Health Plan Compliance, Privacy and Legal Notices The July 30, 2020 Texas Medicaid Preferred Drug List was revised, effective September 17, 2020. Find seminars, webinars and other training opportunitiesfor you and your staff. Please call the FEP Provider Services line at 410-581-3568 or 1-800-854-5256. FirstCare Payer ID: 94999; . HSBC Family Goal Insurance Plan. Do not use labels, stickers, or stamps on the claim form. As part of our ongoing fight against the global pandemic, FirstCare and its self-funded groups will be covering the cost of administering COVID-19 vaccines with zero cost-share for our members. Up to 12% off your first-year premium on HSBC Qualifying Deferred Annuity Plans if customer applies together with VHIS Flexi. Contact vdp-formulary@hhsc.state.tx.us (link sends e-mail) for questions or comments. Sorry for the inconvenience. NOTE: Following CDC guidelines for COVID-19, at this time we do not have in-person customer service. Were here to make sure that our members and communities have access to high-quality health insurance at affordable rates. Do not fold claim forms, appeals, or correspondence. If you think Firstcare could be right for you, you can email info@firstcare.ie with your CV and details. October 2022 Drug Utilization Review Board Meeting Summary. We care about the health and well-being of all of our membersas we continue to monitor the spread of COVID-19, we are committed to keeping you informed. A corrected claim is a replacement of a previously submitted claim (e.g., changes or corrections to charges, clinical or procedure codes, dates of service, member information, etc.). Email: customerservice@careoregon.org. 0333 321 8160 Careers. Please ensure recipient email address is valid. ; STAR Medicaid/CHIP Low-income families and Children's Health Insurance Program plans. Below is a list that may assist you with your CareFirst provider-related questions. Medicaid recipients will be notified if their coverage is changing and if they need to take any action. 1-855-TX-RIGHT ( 1-855-897-4448) 8 a.m. to 5 p.m. Central Time, Monday to Friday (except for state-approved holidays) Prior Authorizations and Notifications RightCare: 1-855-691-7947 Pharmacy: 1-877-908-6023 Behavioral Health: 1-855-395-9652 Eligibility Verification (IVR Line) 1-800-925-9126 Compliance Hotline 1-888-484-6977 Additional information is available. Send the letter to the address that appears on your Member ID card. 1-800-431-7798 (STAR) or 18776392447 (CHIP), Monday to Friday, 7 a.m. to 7 p.m. Find a doctor or pharmacy Choose or update your PCP Print a temporary ID card Ask for new ID card Update your personal information Review your Member Handbook Did you know you can change your primary care doctor on our member portal? Contact Us; Forgot Username; Forgot Password . For more information. CareFirst BlueChoice must receive your written appeal within 180 days of the date of notification of the denial of benefits or services. Company Information. Company Information. COVID-19: What you need to know about the outbreak of the coronavirus. The company's filing status is listed as Active and its File Number is 7232924. 11/04/2022. To access covered services, call FirstCare STAR Customer Service at 1-800-431-7798. Visit our contact us page. Sagar Patel is an EDI Specialist at FirstCare Health Plans based in Temple, Texas. All Rights Reserved. Coverage for Medicaid recipients will continue during the public health emergency. Find out about our online tools to save you time. Shawna Aragon 806.467.3204 Regional Email for all Representatives SWHPRegion4@BSWHealth.org Bexar Paul Kuder 737.401.9207Concho, Crockett, Irion, McCulloch, Mason, Menard, Schleicher, Sutton, Tom Green Denese Montes 806.784.4433Hudsbeth, Medina, Zavala Christye Cottrell 806.784.4485Edwards, Kinney, Val Verde If you want to remain on these pages, click Cancel or close this box. We're always looking for talented people to join us. Call Monday through Friday, from 7 a.m. to 7 p.m. Central Time (CT). If you want to remain on these pages, click Cancel or close this box. Step 2: Submit A Written Appeal. Password length must be at least 8 characters and contain an upper case and a lower case letter, a number, and one of the following special characters: Claims mailing address: 2364 WOODLAKE DRIVE, OKEMOS, MI, 48864: 517-347-2343: CAPITOL INDEMNITY CORP Claims mailing address: PO BOX 5900, MADISON, WI, 537050900: 608-829-4834: CHARTIS INSURANCE Claims mailing address: P.O. Tricare for life Claims address. Learn more today about our individual/family plans, STAR and CHIP coverage options. US and US Territories. Check out our Value-Added Services (VAS) program details! Please ensure your email address is valid. Find out more, The Health and Human Services Commission (HHSC) adopted emergency rules in response to the state of disaster declared in Texas and the United States of America related to COVID-19. The Registered Agent on file for this company is Corporation Service Company and is located at 251 Little Falls Drive, Wilmington, DE 19808. 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