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How to File a Complaint

CHIP/CHIP Perinatal

What should I do if I have a complaint? Who do I call? Can someone from CFHP help me file a complaint?

We want to help. If you have a complaint, please call us toll-free at 1-800-434-2347 or send a written request to:

Community First Health Plans
12238 Silicon Drive, Suite 100
San Antonio, TX 78249
Attention: Member Services Resolution Unit

to tell us about your problem. A Community First Health Plans Member Services Advocate can help you file a complaint. Just call 1-800-434-2347. Most of the time, we can help you right away or at the most within a few days.

In addition, CHIP members MUST return this complaint form to file a written complaint.

If I am not satisfied with the outcome, who else can I contact?

If you are not satisfied with the answer to your complaint, you can also complain to the Texas Department of Insurance by calling toll-free to 1-800-252-3439. If you would like to make your request in writing, send it to:

Texas Department of Insurance Consumer Protection
P.O Box 149091
Austin, TX 78714-9091

If you can get on the Internet, you can send your complaint in an email to http://www.tdi.texas.gov/consumer/complfrm.html.

How long will it take to process my complaint?

If you call to file a complaint, we will mail you a letter within 5 calendar days from the date you call to tell you we received your complaint. We will also send you a complaint form.

What are the requirements and timeframes for filing a complaint?

After you return the complaint form, we will mail you a letter within 5 calendar days from the date we received your form to tell you we received it. We will mail you our decision within 30 calendar days.

Send your complaint to:

Member Services
Community First Health Plans
12238 Silicon Drive, Suite 100
San Antonio, TX 78249

What if I am not satisfied with the outcome, whom else can I contact?

If you are not happy with our answer, you can file a complaint appeal in writing. Call our Member Services Advocates. If you file a complaint appeal, we will mail you a letter within 5 calendar days from the date we received your form to tell you we received it. We will schedule an Appeal Panel hearing.

Do I have the right to meet with the complaint appeal panel?

Five calendar days before the hearing, you will receive a letter with important information about your appeal rights. You may appear before the Appeal Panel. After the Appeal Panel hearing, we will send you our answer. We will mail the letter within 30 calendar days from when we received your written appeal.

You can file a complaint with TDI at any time.

If you would like more information regarding the appeal process, please click here. 

Corporate Office

12238 Silicon Drive, Suite 100

San Antonio, TX 78249

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Community Office

1410 Guadalupe Street Ste. 222

San Antonio, TX 78207

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Monday - Friday

8:30am - 5:00pm

Member Services

210-358-6070 Commercial
210-358-6060 Star Medicaid
210-358-6403 STAR Kids
1-855-607-7827 STAR Kids Toll-Free
210-358-6300 Chip/Chip Perinatal
210-358-6080 TDD Local
1-800-390-1175 TDD Toll-Free
210-358-6400 HIE
888-512-2347 HIE Toll-Free

Behavorial Health

210-358-6100 Commercial

Behavorial Health & Substance Abuse

1-877-221-2226 Crisis Hotline 24/7 CHIP and Medicaid

Nurse Hotline

210-227-2347
Toll-Free 1-800-434-2347