Feb 26, 2026 | PEMS, Provider News, Provider Resource
Beginning December 1, 2025, HHSC is requiring a phased approach to claim edits related to CLIA certification Data: Soft Edit Period (No later than March 1, 2026) A soft edit will be implemented to help providers correct CLIA information that does not match the PEMS...
Feb 25, 2026 | Provider News, Provider Resource
Texas continues to see rising rates of congenital syphilis, highlighting the continued vigilance in prenatal care. Early screening, timely diagnosis, and appropriate treatment during pregnancy are critical to preventing transmission and improving outcomes for infants....
Nov 1, 2023 | HHSC News, Provider News, Provider Resource
Community First Health Plans does not accept eligibility requests via any clearinghouse. To verify Member eligibility, refer to our comprehensive Provider Quick Reference Guide and get in touch with the Member Services department corresponding to your specific line of...
Jan 21, 2026 | Provider News, Provider Resource
A strong, arctic cold front is expected this week, beginning Saturday, January 24, and lasting through Monday, January 26. Freezing weather can be dangerous. We want to make sure our community is prepared. Here are some helpful resources. Please share with...
Jan 20, 2026 | Provider News, Provider Resource
Effective February 1, 2026, the Texas Department of Insurance (TDI) will require all applicable health plans to use state‑mandated uniform Coordination of Benefits (COB) questionnaires. Health plans must also accept these forms when submitted by either Providers or...
Jan 7, 2026 | Provider News, Provider Resource
Effective January 1, 2026, and applicable to all Community First Marketplace plans (University Community Care Plan), a patient’s health plan of record at the date of an inpatient admission is responsible for payment of all covered inpatient facility and professional...
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