However, Community will confirm the validity of the allied health professional’s license, obtain primary verification that adequate training has been completed, and verify that no previous sanctions have been taken against the Provider by Medicare/Medicaid. Phone number. Contact; Community HealthChoices; Facebook Twitter YouTube Community HealthChoices . Related Topics Related Topics Contact Information/Help for MA Providers … Phone713.295.5007 or toll-free 1.833.276.8306, Complex Care & Discharge Planning:713.295.7030, Inpatient Prior AuthorizationsFax: 713.576.0932, Outpatient Prior AuthorizationsFax: 713.576.0930, Toll-free Provider Services1.877.493.6282, Charter for Provider Engagement Council "PEC", Prior Authorization GuideEffective 09/29/20. Community Health Choice, Inc. (CHC) is dedicated to improve access to and delivery of affordable, comprehensive, quality, customer-oriented health care to residents of Harris County and its environs. With Community, you'll have a TRUSTED partner who respects you and your family, provides access to high quality healthcare, and makes the process … Community Health Alliance offers freedom of choice in selecting a provider. If you represent a third party, you must contact the provider's office. HHSC PHONE NUMBER SCAM: The Health and Human Services Commission (HHSC) no longer uses the toll-free phone number 1-800-248-1078. Visit Us At. Starting Nov. 1, 2017, notification is required for certain genetic and molecular lab tests for certain UnitedHealthcare Commercial benefit plans. 125Houston, Texas 77054, Community Health Choice2636 South Loop West, Ste. If you need assistance using our website or mobile application, or assistance with a document on the website or application, we can help you. Provider Resources; Claims ; Services Requiring Prior Authorization; Compliance; Provider Academy; Provider Academy. Become a Community Provider COVID-19 Updates Resources and information about COVID-19 for Community Providers. THIS FORM MAY BE REPLACED BY AN IPA PROFILE WITH THE APPROPRIATE … As a Medicaid managed care organization, Community Health Choice must utilize the Texas Association of Health Plans’ (TAHP’s) contracted Credentialing Verification Organization (CVO) as part of its credentialing and recredentialing process regardless of membership in the TAHP. Lubbock, TX 79490-6532 For Participants Participants homepage View Your Benefits Participants handbook Find a Doctor, Medicine, or Pharmacy This program gives me hope in our Community. With the rising risk of the Coronavirus, it is important that you call your PCP if you are having symptoms. Labs must register their tests to participate as part of the Genetic and Molecular Lab Testing Notification/Prior Authorization process. Community Care Health is dedicated to providing a level of customer service and support second to none. IPA Affiliation . Medical Assistance provider compliance. Complete the applicable profile form below to request participation in Community’s programs. Save this phone number. Providers do not need to join Patient-Centered Community Care (PC3) to participate in the Veterans Choice Program. Specialties: Community Health Choice is a LOCAL non-profit health plan. Community Health Choice is one of the greatest companies that I know. As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. Lubbock, TX 79490-9011. Community Care Plan strives to provide quality care to you and your family. For your health and ours, we are not offering walk-in assistance at this time. With Community, you'll have a TRUSTED partner who respects you and your family, provides access to high quality healthcare, and makes the process … Community Health Choice is one of the greatest companies that I know. Provider Services. Community Health Choice2636 South Loop West, Ste. Health Choice Arizona network providers can access our secure physical and behavioral health service portals to view claims information, prior authorizations, forms and other resources. Providers do not need to join Patient-Centered Community Care (PC3) to participate in the Veterans Choice Program. Members can always find their specific plan information, including in-network care providers, at myuhc.com ®. Lillington Health Center. Children’s Medicaid covers a child up through the month of his or her 21st birthday. Call Us: Local: 713.295.6704 Toll-Free 1.855.315.5386. Community Health Choice Member Services cares about you. In the event that a CMS site visit is not available or was not conducted, pre-contractual site visits will be completed, based on accreditation status, i.e., non-accredited hospitals, home health agencies, skilled nursing facilities, and free-standing surgical centers. Saturday/Sunday/Holidays9:00 a.m – 12:00 p.m. Website https://provider.communityhealthchoice.org/resources/, Complex Care & Discharge Planning713.295.7030, Websitehttps://visionbenefits.envolvehealth.com/, Inpatient Prior Authorizations713.576.0932, Outpatient Prior Authorizations713.576.0930. Please do not call it. EDI# 71065. Contact us today and let us know how we can help. The Provider Service Center helps with contracting, patient services, precertification and many other questions. 1-800-323-4314. We serve the greater Indianapolis, Johnson, Kokomo and Anderson areas. Access can be granted through this external Wayne State Physician Group link. A site assessment may be recommended at the discretion of the medical director. Setting up your My Member Account is as easy as 1-2-3. We are continuing our normal business hours of operation at the First Choice Community Health Center’s Lillington location. We at Prime Health Choice strive to deliver the best customer service to our members and provide access to care 24 hours a day, 7 days a week. Health Choice Arizona network providers can access our secure physical and behavioral health service portals to view claims information, prior authorizations, forms and other resources. UPMC CHC Participants. English ATTENTION: If you speak another language, language assistance services, free of charge, are available to you. Mid-Level Practitioners include the following disciplines: Allied health professionals who care for Community Members exclusively under the supervision of a credentialed physician are not contracted individually by Community and will not be named in any Member publication. Community Health Choice, Inc. (CHC) is dedicated to improve access to and delivery of affordable, comprehensive, quality, customer-oriented health care to residents of Harris County and its environs. Preferred CommunityChoice PPO, Inc. is one of the managed care subsidiary companies of CommunityCare. Family Choice Health Network 7631 Wyoming Street, Suite 201 Westminster, CA 92683 714-898-0612 714.898.0765 Become a Member How to enroll in Prestige Health Choice. Member Number: ... About Community Community Health Choice, Inc. (Community) is a LOCAL, non-profit health plan that genuinely CARES for and SERVES our community. Behavioral Health/Substance Abuse: Beacon Health Options 1-877-343-3108. On certain holidays, calls will be handled by our automated phone system. Website Email RA-PWCHC@pa.gov. Our provider services team is available Monday through Friday, 8 a.m. to 5 p.m. PT to provide assistance with: Credentialing questions. Submission Information : HealthChoice. Set up your account. 24-hour Nurse Advice Line: 1-800-835-2362; Care Management: 713-295-2303 or 1-855-315-5386; Provider Services: 713-295-6704 Phone, 713-295-2283 Fax; Envolve Vision: 1-800-334-3937; Behavioral Health/Substance Abuse: 1-855-539-5881 PAY BILL FOR MEMBERS. Community First’s Provider Portal is an interactive secure website offered by our health plan for contracted providers. Furthermore, Community will obtain documentation that the supervising physician has secured appropriate malpractice coverage for the employed practitioner if he/she is not independently insured. Contact Us by Phone Providers for Health Care District of Palm Beach; Providers for PPUC. Community Health Choice, Inc. (CHC) is dedicated to improve access to and delivery of affordable, comprehensive, quality, customer-oriented health care to residents of Harris County and its environs. Important Phone Numbers. From the benefits and special programs we offer, to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family. through a partnership with CCW, ... 2020 Community Care Associates Phone: 313-961-3100 or 866-323-3224 Welcome to the Provider Relations department at Community Health Direct (CHD). 40 Autumn Fern Trail. Our prior authorization department will review the request and make a decision. CCHP Provider Relations Representatives: CCHPProviderRelations@chw.org: CCHP Customer Service Center: Phone: 1-800-482-8010: CCHP Clinical Services Department: Phone: 414-266-5707 or 1-844-227-1142: Electronic Claims Submission: Phone: 1-800-482-8010. Memorial Healthcare System (MHS) 954-622-3499. Call us toll-free: 1-844-833-0523 TTY: 711 24 hours a day, seven days a week By Mail and Email. If you have any questions, please contact Provider Services at 713.295.2295 or toll-free at 1.888.760.2600. Our Family Medical Clinics specialize in family practice, including pregnancy and newborn care. Specialties: Community Health Choice is a LOCAL non-profit health plan. ... Behavioral Health provider (253) 589-7030. Please call 713.295.6704 to schedule an appointment or discuss other options for assistance. Change a Provider; View your benefits; Check your payment, invoice or policy history; Live Chat/Text ⓘ Please Note: If there has been a change in your Member ID number, you will need to create a new Member account using your new Member ID number. Provider Login Check eligibility, access claims and submit online authorizations. Box 56099. Choose the appropriate provider portal to access: If you are experiencing technical difficulties with the provider portal, please call our Provider Portal Coordinator at 480-760-4651. Saturday/Sunday/Holidays,9:00 a.m – 12:00 p.m. Phone713.295.2295 or 1.888.760.2600Website, https://provider.communityhealthchoice.org/resources/. Select or change your Primary Care Provider; Send live chat/text messages to our Member Services team; Set up paperless billing; And much more! Apple Health Provider Phone: 1-800-440-1561 (TTY Relay: Dial 711) Medicare Provider Phone: 1-800-942-0247 (TTY Relay: Dial 711) Email: [email protected] Mail: Community Health Plan of Washington 1111 3rd Avenue, Ste 400, Seattle, WA 98101 Fax: … Provider Login ; Tax ID: User ID: Password: Remember: tax IDs should not include hyphens: Remember: passwords are case-sensitive : Did you forget your login ID? In addition to the TSA, the physician will also provide the following attestations upon initial credentialing: Physicians must submit the names of at least two physicians who will provide cross coverage for applicant. If your PCP office is closed, call the free Nurse Call Line at (855) 872-1852.The nurse will help you decide if you need to see a Doctor right away. Members choose an HMO and a Primary Care Provider to give them all their primary care services. In case of emergency, call 9-1-1 or go to the nearest hospital. CCN uses industry-standard approaches and guidelines to administer services, pay for services promptly, and manage the network to its full potential. Behavioral health treatment. Medicaid HoursMonday - Friday, 8:00 a.m. – 5:00 p.m.Saturday/Sunday/Holidays, 9:00 a.m – 12:00 p.m. CHIP HoursMonday - Friday, 6:00 a.m. – 6:00 p.m.Saturday/Sunday/Holidays, 9:00 a.m – 12:00 p.m. Websitehttps://provider.communityhealthchoice.org/resources/, Outpatient Prior Authorizations713.576.0931. 954-622-3499. In the case of non-accredited institutions where the Health Plan is required to perform a site visit, the health plan may substitute a CMS review as a site visit if available. Member Services; Provider Relations Upon receipt of your signed contract and “Completed” Credentialing file from Aperture (CVO), the credentialing process can take up to 90 days. Community Health Choice P O Box 301424 Houston, TX 77230-1424 Toggle navigation ES. Samaritan Health Plans provider portal: Provider Connect. CHC will replace the state’s Medicaid waiver programs for individuals age 21 and older and seniors who need long-term care. As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. If your medical condition is beyond our primary care services, we will assist you in finding the specialized care you need at a price you can afford. If you have further questions or feel you are still in disagreement, you may file a request for reconsideration of a claim within 180 days of receiving the initial EOP. Fax Number Not Working? NOTE: The VA contract with HNFS as a third-party administrator for the PC3/Choice networks ended on September 30, 2018. Find a Doctor, Drug, or Pharmacy Search for a primary care provider, specialist, or hospital near you. Hours Monday - Friday8:00 a.m. – 5:00 p.m. On certain holidays, calls will be handled by our automated phone system. Provider Reimbursement Fax: 1-800-753-8744 Network Development Fax: 1-866-534-9759 Coordination of Care Line: 1-844-488-5336. Phone 713.295.6704 or 1.855.315.5386. At Community, we genuinely CARE for and SERVE our Community. https://visionbenefits.envolvehealth.com/. NOTE: Community Health Choice is not affiliated … Your feedback, questions, and concerns are always welcome. If you are currently part of an IPA, please contact them to determine if they currently have an agreement in place with Community. We are your one-stop shop for contracting, credentialing, and service and educational needs. Hospital-based specialties are identified as follows: RadiologyAnesthesiologyPathologyNeonatologyThe specialty Providers listed above who practice exclusively in a hospital setting do not require completion of the same credentialing process as other independent practitioners, in accordance with NCQA and URAC guidelines. See More. Personal Information. Here you'll find phone numbers, addresses, emails and other contact information to help support providers. Call: Medi-Cal: 1-800-224-7766, Cal MediConnect: 1-888-244-4430 (TTY: 1-855-266-4584). COMMUNITY CARES Providing superior care to our Members together. Call Provider Services at 1-800-617-5727 to speak to a representative. ... 1-866-224-5701. For non-accredited hospitals, home health/infusion therapy, skilled nursing facilities, free-standing surgical centers, and all other types of non-accredited organizations recruited to care for Community Members within their facilities, in addition to facility licensure and the review of policies and procedures for verifying the licenses of key personnel, a review of the care site using the attached assessment tool and interviews with key personnel or a CMS site review report, and evaluation of data collected such as quality improvement (QI) and utilization management (UM) plans, are the basis for determining participation with Community. Important:  Please ensure that your credentials and information are current to avoid any delays in the credentialing or recredentialing process. Specialty directories for dental, behavioral health, Employee Assistance Program and mental health providers as well as OptumRx pharmacy locators are also available. If a site visit is conducted, in lieu of collecting licenses of all key personnel as part of the review, policies and procedures outlining the verification process may be reviewed on-site and documented. Community is not only responsible for the review and selection of accredited institutions, but also has the responsibility for assessing the safety of the physical environment and quality of health care provided to Members by non-accredited institutions. Community Health Choice Member Services cares about you. Ordering care providers will complete the notification/prior authorization process online or over the phone. Call Community Health Choice to get an interpreter. SEE PLANS. With local staff available to answer any questions or address any issue you may have, we look forward to working with you to ensure there is never a disruption to your healthcare needs. Download PDF Version. However, if the above mentioned specialists provide services to patients outside the hospital, e.g., skilled nursing facilities, outpatient surgery centers, urgent care centers, free-standing emergency rooms, or any other type of ambulatory setting, full credentialing must be completed prior to granting/renewing privileges of participation in Community’s delegated network. Click here if you are an existing user and would like to reset your password. Providers. 1-800-434-2347 TTY (210) 358-6080. Community Health Alliance, as a provider owned managed care organization, has an advantage over competitors due to the maintenance of local control and the ability to respond to customer demands in a timely manner. Provider Relations Inquiries: 713-295-2295. All the important contact information you will need, all in one place. Customer Service representatives for Community Care Health are accessible by phone at 1-855-343-2247, and are available to assist the speech and hearing impaired. Health delivery organizations as defined by the National Committee for Quality Assurance (NCQA) include, but are not limited to: The credentialing standards of participation for health delivery organizations have been developed in conjunction with NCQA and URAC standards to accomplish a judicious selection process in order to maintain and improve network selection. Español (Spanish) UPMC Health Plan Attn: UPMC Community HealthChoices U.S. Steel Tower, 10th Floor 600 Grant Street Pittsburgh, PA 15219 Email: chc@upmc.edu; Search. Community Health Care has many medical and dental providers to choose from. Please call us toll-free at 1-866-842-3278. Physicians who are selected by the applicant as providing cross coverage must be credentialed by Community and complete and submit an application form as well as fulfill requirements of 1-8 above. Health Choice Coverage of Michigan / Detroit . Contact CHC Member Services if you do not receive the email from us. Community HealthChoices (CHC) ... while at the same time creating a person-driven, long-term support system in which people have choice, control and access to a full array of quality services that provide independence, health, and quality of life. Newsletter CHIP is a health insurance plan for children under the age of 19 and is designed for families who earn too much money to qualify for Texas Medicaid programs yet cannot afford to … The Coordination of Care Phone Line provides a single point of contact when needing to reach Community Care for care coordination regarding: Community HealthChoices; Physical Health/Behavioral Health Initiatives Most times they can research and provide answers immediately. NETWORK PROVIDER UPDATE FORM (PUF) MEDICAID. Our hours of operation are 8 a.m. – 5 p.m. Individual and Family. We will also continue to provide after hour care as usual with our on-call service. Community Health Choice, Inc. (Community) is a LOCAL, non-profit health plan that genuinely CARES for and SERVES our community. On October 1, 2018, HNFS opened the new provider service line for VCP and PC3 claims questions related to HNFS-authorized services that is listed here. CHC will coordinate your health care coverage to improve the quality of your health care experience — serving more people in communities rather than in facilities, giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life. Our hours of operation are 8 a.m. – 5 p.m. Send us your questions! We are a TRUSTED partner who RESPECTS our Members and their families, opens doors to high-quality… Members Rights and Responsibilities Information on Members Rights and Responsibilities including referrals and prior-authorization. Community First Health Plans has a Nurse Advice Line available 24 hours a day, 7 days a week, 365 days a year – to help you get the care you need. EDI Payer Number: 39113. Manage your Employer Health Plan, employee enrollments, and view and pay your bill. Workers’ compensation coverage certification, as applicable, Number of Medicare approved beds (attach copy of letter), Department of Health and Human Services letter/certificate, as applicable, Letter from AHCA with provisions specific to the state of Texas (applicable to dialysis centers), Copy/listing of all current state licenses for medical personnel or policy/ procedure on verification process of licenses for medical personnel, Federal DEA Registration for Medical Director, as applicable, Texas Clinical Laboratory Law Certificate of Licensure, as applicable, Resume/curriculum vitae and credentials of medical director, as applicable, Resume/curriculum vitae of administrator/executive director or key management staff, as applicable, Current Occupational License (County/City), as applicable, Necessity of site visit for the above non-accredited facilities to be determined by the regional medical director, Facility has no known recognized accreditation body, Interpartum, postpartum and newborn protocols, Medication policies and approved medication. Small business health coverage is. All Rights Reserved. If you have a question or concern, please contact us. Phone number. You can access services by calling Member Services at 1 (855) 777-4630 or TTY/TDD: 1 (855) 777-4613 Learn More. Read More Provider Newsletter Get the latest on Community in our 2020 […] Providers interested in participating must establish a contract with one of the contractors, Health Net Federal or TriWest Healthcare Alliance. DISCOVER OUR PLANS. ... Community Care Associates/Health Choice of Michigan. Waste, Fraud and Abuse Hotline: 1-877-888-0002. Directors and Officers Liability coverage or Errors and Omissions Policy. Physicians of all disciplines are invited to participate including: Physicians should complete the Texas Standardized Application (TSA). Call us to get an interpreter. If non-accredited, explanation for non-accreditation must be provided to include time frame in which the facility intends to seek accreditation. Find a doctor, medicine, pharmacy, or transportation; Prior authorization lookup tool; Behavioral health Home; About; Our programs; How to apply ; What's new; For members; FAQS; 1095B TAX FORM; Contact; HealthChoice of Michigan. These services are available for any Keystone First Community HealthChoices member through your local county mental health … CHC call centers are now open! Contracting (existing or new). Community First’s Provider Portal is an interactive secure website offered by our health plan for contracted providers. In the event Community elects to contract with a health delivery Provider other than those aforementioned, Community will ensure, prior to contracting, that the Provider has met all state and federal licensure requirements and is free from any Medicaid/Medicare sanction activity. Community Health Care has many medical and dental providers to choose from. NOW AFFORDABLE. HHSC never asks for credit card information over the phone. #222 San Antonio, TX 78207 Phone (Main) Phone: 210.227.CFHP(2347) (Toll-Free) Phone: 800.434.CFHP(2347) Visit our contact page Copyright 2020 Community Health Choice. We want to thank our providers for helping to make Prestige Health Choice a better health care plan. (855) 624-6463 (855) 624-6463. Welcome, Community HealthChoices Providers! The Wolf Administration developed CHC in 2015 with the goal to (1) enhance access to and improve coordinatio… Community participates in the Children's Health Insurance Program (CHIP), including CHIP Perinatal (CHIP-P). Provider education and training. We speak English, Spanish and other languages, too. Income determines eligibility. … Effective Date. Nurse Advice Line. Dental, Vision, … Children's Medicaid. 1-800-935-5669. The Council for Affordable Quality Healthcare (CAQH). Contact CHC Member Services if you do not receive the email from us. All health delivery organizations requesting participation with Community must either be Medicare-/Medicaid-approved Providers and suppliers or provide evidence of eligibility. https://provider.communityhealthchoice.org/medicare, https://visionbenefits.envolvehealth.com/, Member Services: 713.295.6704 or 1.855.315.5386, 24-hour Nurse Advice Line: 1.800.835.2362, Care Management: 713.295.2303 or 1.855.315.5386, Provider Services: 713.295.6704 Phone, 713.295.2283 Fax, Behavioral Health/Substance Abuse: 1.855.539.5881, 24-hour Nurse Advice Line: 1-800-835-2362, Care Management: 713-295-2303 or 1-855-315-5386, Provider Services: 713-295-6704 Phone, 713-295-2283 Fax, Behavioral Health/Substance Abuse: 1-855-539-5881, Work history covering the last five years, A statement by the applicant regarding any limitations in ability to perform the functions of the position with or without accommodation, A history of loss of license and/or felony convictions, A history of loss of limitation of privileges, sanctions, or other disciplinary activity, Information on current professional liability insurance coverage, Information on whether the individual Provider will accept new patients from the HMO, Optometrist (OD) – Contact Superior Vision, Psychologist (Ph.D.) – Contact Beacon Health Strategies, Licensed Social Worker (LMSW) – Contact Beacon Health Strategies, Must maintain a current and active license to practice midwifery in the State of Texas, Must provide written confirmation of having secured access to an obstetrical physician, as needed, which physician must be a participating Provider with Community, and have active hospital privileges with a facility contracted by Community, and located within the midwife’s practice area, Must carry a minimum malpractice insurance in the amount of $100,000 per occurrence/$300,000 per policy period, Must provide written attestation that all deliveries of low-risk Members will be completed in contracted birthing centers or hospitals, Must provide evidence of a minimum of three years experience as a practicing midwife, Must be a registered nurse in the State of Texas, Must maintain an active practicing certificate as a nurse midwife, Must provide written confirmation of having secured access to an obstetrical physician, as needed, which physician must be a participating, Provider with Community, and have active hospital privileges with a facility contracted by Community, and located within the nurse midwife’s practice area, Must have active hospital privileges, as a nurse midwife with a facility contracted by Community, Must carry a minimum malpractice insurance in the amount of $200,000 per occurrence/$600,000 per policy period, Must provide a written attestation that deliveries of all Community Members will be completed in birthing centers or hospitals contracted by the Community, Must provide evidence of a minimum of three years experience as a certified nurse midwife, Must agree to request laboratory and/or diagnostic tests through assigned primary care physicians (PCP) or supervising OB/GYN contracted by Community, Completed, dated and signed application for participation in Community, Current copy of State licensure (HRS/AHCA), Copy of current JCAHO, AAAHC and/or CARF accreditation report (whichever is applicable), Malpractice and/or general liability insurance limits of $100,000/$300,000, Workers’ compensation coverage certification, Medicaid/Medicare certification number (attach copy of approval letter), Copy/listing of all current State licenses for medical personnel or policy/ procedure on verification process of licenses for medical personnel, Federal DEA Registration for medical director, Resume/curriculum vitae and credentials of medical director, Resume/curriculum vitae of administrator/executive director or key management staff, Proof of Federal Tax Identification Number, Current copy of state licensure (HRS/AHCA), Malpractice and/or general liability insurance, Number of certified Medicare beds (attach copy of letter from CMS), Department of Professional Regulation Board of Pharmacy License (applicable if pharmacy is located at the facility or dispenses medication), Copy of all current state licenses for medical personnel or policy/procedure on verification process of licenses for medical personnel, Federal DEA Registration for Medical Director, Clinical Laboratory Improvement Amendment, as applicable, Clinical Laboratory Law Certificate of Licensure, as applicable, Mammogram Certification (based on scope of services), Radioactive Materials License/Department of Health and Rehabilitative Services Office of Radiation Control (State Department License for Rehabilitation), Resume/curriculum vitae of administrator, executive director and key management staff. 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