Provider News
Summer 2026 Provider Newsletter Now Available!
The Community First Summer 2026 Provider Newsletter is now available. This issue features important updates, compliance guidance, Provider Portal enhancements, care coordination resources, quality initiatives, and clinical tools designed to support your practice and...
Implant Billing and Reimbursement Guidelines for Inpatient and Outpatient Services
Community First Health Plans is providing guidance on billing and reimbursement requirements for implantable devices for both inpatient and outpatient hospital services. Proper coding and documentation are required to ensure accurate claims processing and to avoid...
Marketplace Grace Periods: Guidance for Providers
Members enrolled in a Marketplace health plan are responsible for paying their premium each month. Members that do not make their premium payments in a timely manner enter a grace period, which begins with the first month a payment is missed.During the grace period,...
Wheeled Mobility Systems: QRP Seating Assessment and Billing Guidance
Community First Health Plans is providing guidance on billing requirements for services performed by a Qualified Rehabilitation Provider (QRP) related to wheeled mobility system and wheelchair seating assessments and fittings. Proper adherence to these billing...
Emergency Preparedness for Hurricane Season: HHSC Provider Guidance
Community First Health Plans is sharing guidance from the Texas Health and Human Services Commission (HHSC) regarding emergency preparedness for the Atlantic hurricane season, which runs from June 1 through November 30. Providers are encouraged to review and update...
Claims Processing After Retro-Termination for Marketplace Members
Effective June 15, 2026, and applicable to all Community First Marketplace plans, claims for dates of service during a Member's policy grace period that were previously paid may be adjusted or recouped if the Member’s coverage is retroactively terminated due...