Verifying Eligibility
As we transition to a new claims system, the correct portal to verify eligibility will vary by member. Most members can be verified through swhpprovider.firstcare.com. Otherwise, please visit portal.swhp.org/providerportal. Note that the applicable provider portal is listed on the member’s ID card.
COVID-19 Updates
COVID-19 testing and vaccinations are available to health plan members at zero out-of-pocket cost. Click here for more information and benefit updates.
Provider/Physician Notice
View the COVID-19 Telehealth and Telemedicine Policy for coding guidelines and claims submission procedures. We have also reduced our Prior Authorization Requirements.
Provider Update: COVID-19 Vaccine
As part of our ongoing fight against the global pandemic, FirstCare and its self-funded groups will be covering the cost of administering COVID-19 vaccines with zero cost-share for our members. This applies to fully insured and self-funded commercial members, as well as our Medicare and Medicaid members. Find out more here.
CMS Hospital Without Walls Initiative
The Health and Human Services Commission (HHSC) adopted emergency rules in response to the state of disaster declared in Texas and the United States of America related to COVID-19. As part of the CMS Hospital Without Walls initiative, hospitals can provide hospital services in other healthcare facilities and sites not currently considered to be part of a healthcare facility or set up temporary expansion sites to help address the urgent need to increase capacity to care for patients, in response to the COVID-19 pandemic. Additional information is available here.

Providers

Effective January 1, 2019, Scott and White Health Plan, part of Baylor Scott & White Health, acquired FirstCare Health Plans. The acquisition allows 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. 

For more information, visit FirstCare.com/SWHP.
 

Interested in Becoming a New Provider?

We’re always looking for exceptional providers to join our growing network of physicians and hospitals. Together, we can help you give your patients—and our members—the quality, cost-efficient care they deserve. Click here to learn more.
 

Contact Your FirstCare Provider Relations Team

Our Provider Relations Team is here for you. If you have questions or need support, please click here to find contact information.


Quality Improvement Subcommittee (QIS)

The Quality Improvement Subcommittee (QIS) 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

Navigating Higher Prescription Drug Costs with Your Patients

Drug prices have continued to rise at an unmatched rate, despite the pandemic. Pharmaceutical companies increase drug prices annually in January and often again in July. Learn more about how drug pricing impacts your patients and get tips for prescribing lower-cost alternatives to brand name drugs.

Changes to Hepatitis C Prior Authorization Criteria Begin September 1, 2021

For additional information click here.

View all provider news >

We're here to help.

Our Provider Relations Team is here for you. If you have questions, please click here to find contact information.


The National Committee for Quality Assurance (NCQA) awarded FirstCare Health Plans an Accredited Status (Commercial, Medicaid, Marketplace HMO, recertified 03/2021) - reflecting our continuous work to fulfill NCQA requirements for consumer protection & quality improvement.

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