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 Physicians and Providers (per TAC § 11.1402)

Tuesday, January 30, 2018

 
SHA, L.L.C. dba FirstCare, 12940 N. Hwy 183, Austin, TX 78750, a basic health service, individual practice model health maintenance organization, will accept written applications during the period of February 1, 2018, through February 20, 2018, from physicians and providers who wish to participate in the FirstCare network. FirstCare offers services for the following products:  STAR Medicaid and CHIP, Commercial and Federal Marketplace. Marketplace applicants must FirstCare’s practice standards and qualifications for acceptance. Applicants will be notified in writing of acceptance or non-acceptance within 90 days after FirstCare receives an application for participation. Applications should be sent to the attention of the Provider Relations Department.

IMPORTANT—Upcoming Changes to Out-of-Network Lab Coverage

Friday, January 26, 2018

 
At FirstCare, we strive to make our health plans affordable and reduce out-of-network utilization. As such, the following changes will go into effect on March 1, 2018:
  • FirstCare HMO members will no longer be covered for unauthorized lab services (i.e., blood tests, biopsies, etc.) when provided by out-of-network lab providers.
  • FirstCare PPO members will no longer receive in-network benefits for unauthorized lab services billed from out-of-network providers.
Please remember that all FirstCare Health Plans participating providers have an obligation to refer FirstCare members to other in-network providers for services, including labs. If your practice currently uses a lab that is not in the FirstCare provider network, or if you refer FirstCare members to an out-of-network lab, please consider how this results in higher health care costs for your patients.
 
In the next few weeks, you will receive a letter with more details on this change, as well as a list of in-network laboratory providers for your patients covered by a FirstCare plan.
 
If you have any questions—or if you need additional information regarding in-network options for laboratory services—please contact the FirstCare Provider Relations team.
 
Thank you for your continued support and dedication to our members.

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 Requirement Changes Effective 11/1/2017 
Referrals & Case Management
Making Referrals & Working with FirstCare Case Management Updated 1/11/2017


The National Committee for Quality Assurance (NCQA) has awarded an accreditation status of Accredited for service and clinical quality that meet the basic requirements of NCQA's rigorous standards for consumer protection and quality improvement.

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