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

STAR—Additional Payable Diagnosis Code for Procedure Code J1300 Eculizumab

Thursday, January 24, 2019

 
Effective for dates of service on or after February 1, 2019, diagnosis code G7000 may be reimbursed when submitted with Eculizumbab procedure code J1300.  Click here for details.

 

Scott and White Health Plan Acquires FirstCare Health Plans

Thursday, January 3, 2019

We are pleased to announce that, effective January 1, 2019, Scott and White Health Plan, part of Baylor Scott & White Health, has acquired FirstCare Health Plans.
 
This acquisition will allow these two provider-owned health plans to come together to create a more comprehensive and sustainable insurer with a driving focus on enhancing the customer experience through advanced technology.
 
The organizations are now beginning the important work of transitioning into one, first-rate organization to provide our members, providers, agents and employees with a best-in-class experience. They are excited to learn from each other and grow together over the coming weeks and months—all to better serve you and your patients.
 
Collectively, the plans cover nearly 400,000 members. Once finalized, the acquisition will mean for those members an expanded network of providers in the communities the health plans serve.
 
“Both of our teams bring incredible expertise and passion to the work we do every day. We are excited to learn from each other and grow together over the coming months to increase access to the services Texans need,” said Jeff Ingrum, President and CEO of Scott and White Health Plan.
 
IMPORTANT:  We do not expect you or your FirstCare patients to experience any immediate changes to FirstCare’s coverage and benefits.

For more information, visit FirstCare.com/SWHP
 

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 Matrix Effective 2/1/2019 
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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