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COMMUNITY CARES Providing superior care to our Members together. Become a Community Provider Community Cares Connecting you to the best health insurance for every stage of life. Become a Community Provider COVID-19 Updates Resources and information about COVID-19 for Community Providers. Read More Provider Newsletter Get the latest on Community in our 2024 Vol 1 Provider newsletter. Read More Texas Health Steps Training Keep up-to-date with annual mandatory Texas Health Steps. Read More Provider Notices Read all about important notices. Read More COVID-19 Updates Resources and information about COVID-19 for Community Providers. Provider Newsletter Get the latest on Community in our 2023 Vol 4 Provider newsletter. Annual Mandatory Texas Health Steps Training Keep up-to-date with Texas Health Steps. Provider Notices Read all about important notices. Marketplace Plans Community proudly offers individual health insurance in the new Health Insurance Marketplace. With a range of plan options to fit any budget, and a network of doctors you can trust, like Memorial Hermann, Community makes it easy to get the care you need and deserve. View Plan Provider Manual Prior Authorization Information Medicare D-SNP Community’s (HMO D-SNP) plan offers additional benefits and services not covered under Original Medicare, such as dental, hearing aids, and vision. You keep all your Medicaid benefits. You get all of Original Medicare’s covered services. You may be eligible if you have Medicare Parts A and B, qualify for Texas Medicaid QMB or QMB+ and live in our service area. View Plan Waiver of Liability Provider Manual Prior Authorization Information Texas CHIP Plan Community participates in the Children’s Health Insurance Program (CHIP), including CHIP Perinatal (CHIP-P). 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 buy private insurance. CHIP-P provides prenatal care for the unborn children of low-income women who do not qualify for Medicaid. View Plan Provider Manual Prior Authorization Information Texas STAR (Medicaid) Plan Community participates in the State of Texas Access Reform (STAR) Managed Care Program (Medicaid). As a part of Medicaid, Community provides both Children’s Medicaid and Medicaid for pregnant women. These programs are at no cost to U.S. residents who cannot afford health insurance. View Plan Provider Manual Prior Authorization Information Texas CHIP Plan Community participates in the Children’s Health Insurance Program (CHIP), including CHIP Perinatal (CHIP-P). 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 buy private insurance. CHIP-P provides prenatal care for the unborn children of low-income women who do not qualify for Medicaid. View Plan Provider Manual Prior Authorization Information Texas STAR (Medicaid) Plan Community participates in the State of Texas Access Reform (STAR) Managed Care Program (Medicaid). As a part of Medicaid, Community provides both Children’s Medicaid and Medicaid for pregnant women. These programs are at no cost to U.S. residents who cannot afford health insurance. View Plan Provider Manual Prior Authorization Information Marketplace Community proudly offers individual health insurance in the new Health Insurance Marketplace. With a range of plan options to fit any budget, and a network of doctors you can trust like Memorial Hermann, Community makes it easy to get the care you need and deserve. View Plan Provider Manual Prior Authorization Information Medicare D-SNP Community’s (HMO D-SNP) plan offers additional benefits and services not covered under Original Medicare, such as dental, hearing aids, and vision. You keep all your Medicaid benefits. You get all of Original Medicare’s covered services. You may be eligible if you have Medicare Parts A and B, qualify for Texas Medicaid QMB or QMB+ and live in our service area. View Plan Provider Manual Prior Authorization Information Provider ResourcesHelpful Links Community’s Preferred Authorization Form Cultural Competency Electronic Visit Verification (EVV) HHSC Notifications HIV and STDs Information Maternity Case Management Program Member RightsResponsibilities Nursing Facility Rate Tables PCP Toolkit Prior Authorization Information ProgenyHealth effective October 25, 2023 Provider Advisory Group Provider ComplaintsAppeals Provider Continuing Education (CE) Provider NoticesReminders Provider Training Texas Health and Human Services Commission Texas Health Steps Provider Information Texas Medicaid/CHIP Vendor Drug Program Texas Medicaid Provider Procedures Manual (TMHP) Texas Standard Authorization Form Texas MedicaidHealthcare Partnership (TMHP) Notice In addition to updating information with Community Health Choice, Providers must: Update your enrollment and demographic information with TMHP (Texas Medicaid Healthcare Partnership). TMHP is HHSC’s provider enrollment administrator and serves as the authoritative source for HHSC Providers’ enrollment and demographic information. Once you update your enrollment and demographic information with TMHP, your data will be reconciled with the demographic information on file with the MCOs. To make updates to your current enrollment (e.g., new practice locations or change of ownership updates), please access the web page titled Provider Enrollment on the Portal – A Step-by-Step Guide” at the following URL: https://www.tmhp.com/sites/default/ files/microsites/enrollment/index.html. For instructions on how to make other demographic updates to your current enrollment, please access the document titled Provider Information Management System (PIMS) User Guide” at the following URL: https://www.tmhp.com/sites/default/ files/file-library/edi/PIMS-user-guide-r2020-11- 19.pdf. Otherwise, you can contact TMHP directly at 800-925-9126 for assistance. Provider Services Hours: Monday – Friday, 8:00 a.m. – 5:00 p.m. Local: 713.295.2295 Toll-free: 1.888.760.2600 Email: ProviderWebInquiries@ CommunityHealthChoice.org Provider Relations Email: [email protected] Why Choose Community? As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. 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. Community Health Choice is always there to answer my questions and help me and my family with our medical needs. I truly appreciate and value their customer support and service.” – Cecily Member of Community Health Choice Community Health Choice Texas, Inc. 4888 Loop Central Dr. Suite 600 Houston, TX 77081 CONNECT WITH USProvider Home Our Plans Texas STAR Medicaid Plan Texas CHIP Plan Health...