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AAPCA Continuity of Care Update

August 31, 2017

IMPORTANT UPDATE

Adoption Assistance and Permanency Care Assistance

STAR & STAR Kids Membership

Continuity of Care Authorization Confirmation

In conjunction with the TMHP Transitioning Authorization file for active authorizations previously approved by TMHP, Community First Health Plans, Inc. (CFHP) will honor the service(s) covered in the TMHP authorization approval, for an additional 90 days or until the expiration of the authorization or until the authorized visits/units are depleted, whichever is sooner. There is no need for providers to submit an authorization request to CFHP for existing active authorizations and CFHP will not issue an authorization for these continuity of care requests.

Prior to the authorization expiration date and/or the units being depleted, Providers should submit a new authorization request with supporting clinical information to CFHP. Online authorization requests can be made at www.cfhp/providers.

If you disagree with the TMHP Prior Authorization or believe your request should be considered as a “New” request, please contact the CFHP STAR Intake Team and work with our Intake staff to resolve the authorization request.

CFHP Authorization Line: (210) 358-6050 Option 3

Please note that an authorization is NOT a guarantee of payment. Services billed to CFHP are considered at the time of clean claim presentation and are based on the Member’s eligibility status, benefits, benefit rules, Texas Medicaid Health Partnership and CFHP claim adjudication rules for the STAR program in effect on the Date the Service(s) were provided.

Providers are reminded to use HIPAA compliant, current coding for transition, continuity of care services when billing CFHP for these previously authorized TMHP services. 

To view/download the AAPCA Continuity of Care Update in PDF format, please click here.