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Authorization Information

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Provider directories:

STAR (Lubbock)
STAR (MRSA)
CHIP
Virtual Urgent Care

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Contact Us!

8 a.m.-5 p.m. weekdays

...excluding state-approved holidays.

We can help you find a doctor, schedule a checkup or answer any questions you have about your benefits.

If you call after hours, please leave us a message. We return all calls the next business day.

Our Customer Service Representatives speak English and Spanish. If you speak another language, we can connect you with an interpreter.

800-431-STAR (7798)

877-639-CHIP (2447)

Members with hearing loss can call the Relay Texas number 711. Relay Texas is a free telephone interpreting service to help people with hearing or speech disabilities.

Resources

Talk to a Nurse—Nurse24™

Need care advice?

Should you see a doctor?

Get answers 24/7! Information is available in English and Spanish. Interpreter services available upon request.

855-828-1013

TTY users: 711 or 800-955-8771

Voice communication: 800-955-8770

Healthy Texas Women Plus

Texas HHSC implemented Healthy Texas Women (HTW) Plus, an enhanced, cost-effective and limited postpartum services package for women in the HTW program. HTW Plus will be provided for no more than 12 months after the start date. Women in HTW Plus will have access to HTW and HTW Plus benefits.

healthytexaswomen.org

Utilization Management

Ever wonder how we decide to authorize services? Our decisions are based on medical evidence and consensus of health care professionals.

Utilization Management Decisions

Health Plan Decisions

State Fair Hearing

Members who disagree with the health plan's decision have the right to ask for a fair hearing only after exhausting the MCO Internal Appeal System provided by FirstCare. Ask for a State Fair Hearing by contacting us toll free. Our Member Services can help you file a fair hearing.

External Medical Review

Members sho disagree with the health plan's decision have the right to ask for a State Fair Hearing (standard or expedited) only after exhausting our Internal Appeals process or you can ask for a State Fair Hearing with an External Medical Review (EMR) (standard or expedited). You cannot only ask for an External Medical Review. An EMR is an optional, extra step for the member to have a case outside the Hearing, free of charge. To request an EMR, call us.

800-431-7798 / TTY 711.

Non-Emergency Medical Transportation (NEMT)

833-779-3105

access2care.net/texas View more information

Prescription Benefits Manager

855-897-4448

Navitus Health Solutions

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