Dear Valued Zelis® Customer: Zelis® is utilizing a maintenance window for the Core Product from 5:00 P.M. (ET) – 8:00 P.M. (ET) on Saturday, April 18, 2026. The System Availability chart below outlines the affected services.
THIS INFORMATION APPLIES TO PROVIDER REFUNDS ONLY. If you believe you have received an overpayment from Community First Health Plans or we have identified an overpayment and requested a refund, please submit the following : A check issued to Community First Health...
Community First Health Plans is currently conducting its annual Provider Satisfaction Survey as part of ongoing quality improvement efforts. A random sample of Providers will be selected to participate. The survey gathers feedback on your experience working with...
A healthier Member is our goal, and it starts with reliable transportation. Community First Health Plans partners with SafeRideHealth to provide an improved Member experience through their transportation benefit program. Non-emergency medical transportation (NEMT)...
Read about the Revised Implementation Timeframes of CLIA Certification Data here. All Providers who perform or bill laboratory services must comply with the Clinical Laboratory Improvement Amendments (CLIA). To meet these requirements, Providers must have an active...
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...
Open Enrollment begins November 1! Community First offers qualified health plans on the Health Insurance Marketplace® for every budget and health care need. Questions? Call 1-888-512-2347 to speak with our licensed Marketplace team.
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