Providers

Why work with FirstCare?

Like you, we are deeply committed to doing the right thing for the health of our communities. FirstCare is Texas-based and provider-owned, so we know what it means to deliver quality care, right here. We want doctors to be in charge of patient care. We’ll do everything we can to help you achieve better patient outcomes.
 
Partnering with FirstCare can connect you with more than 4,600 contracted facilities, including 199 hospitals, and more than 16,400 primary care and specialty providers. Our strong local ties can generate favorable new business — from commercial to government-employed patients — all at competitive, profitable rates. FirstCare has tremendous expertise in compliance, administration, and processing for STAR and CHIP programs. And we do it all with high ease of use, high reliability and low administrative hassle.

Learn More About Becoming a Provider >

 

Contact Your FirstCare Provider Relations Team

Our Provider Relations Team is here for you. If you have questions, please contact your provider relations representative:

Region Phone Email
Abilene 325.670.3882
325.670.3884
 
prabilene@firstcare.com
Amarillo 806.467.3200
 
prsupport@firstcare.com
Lubbock, Waco and
all other areas
806.784.4380 prlubbock@firstcare.com
       

Corporate Medical Advisory Committee (CMAC)

The Corporate Medical Advisory Committee (CMAC) develops, reviews and approves clinical programs and guidelines, studies, and other clinical activities related to the health care services provided to FirstCare members.

 



Provider News

Notice to Providers - New Compliance Hotline

Monday, December 3, 2018

 
In celebration of the 2018 national Corporate Compliance & Ethics Week theme—“Awareness, Recognition, Reinforcement”—FirstCare is delighted to offer providers a confidential and toll-free Compliance Hotline, dedicated to prevention, detection, and resolution of potential instances that do not comply with Federal and State laws. FirstCare implemented this tool to empower our providers to report violations related to Fraud, Waste, and Abuse and HIPAA Privacy and Security. Reports may be made anonymously to allow confidentiality. The hotline is available 24 hours a day, 7 days a week and is accessible by telephone and via website.

To learn more about FirstCare’s Compliance Hotline, click on PDF link below. 
 

Change to Medical Paper Claim Submission: CMS-1500 Form Box 33 (Billing Provider Address)

Tuesday, November 20, 2018

 
Effective February 25, 2019, FirstCare Health Plans will no longer accept P.O. Box addresses in Box 33 (Billing Provider Address) of the CMS-1500 Form. This change is being implemented in order to align with the National Uniform Claim Committee (NUCC) requirements, as adopted by the Centers for Medicare and Medicaid Services (CMS). In accordance, providers are required to, submit the billing provider’s name, physical street address or physical location, and a telephone number in Box 33..

For more details, click on the attached PDF. 
 

View all provider news >

We're here to help.

Our Provider Relations Team is here for you. If you have questions, please email Provider_Relations@FirstCare.com, or contact your provider relations representative at the number below:
  • Abilene area—1.325.670.3882 or 1.325.670.3884
  • Amarillo area—1.806.467.3200
  • Lubbock, Waco & other areas—1.806.784.4380

Resources

Accessing the FirstCare Provider Self-Service Portal
Authorization Requirements
FirstCare Authorization Requirements MatrixEffective 11/1/2017 
Referrals & Case Management
Making Referrals & Working with FirstCare Case Management Updated 1/11/2017


The National Committee for Quality Assurance (NCQA) awarded FirstCare a Commendable Status (Medicaid HMO, 09/2018) & an Accredited Status (Commercial and Marketplace HMO, recertified 02/2018)—reflecting our continuous work to fulfill NCQA requirements for consumer protection & quality improvement.


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