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Prior Authorization

  • Referral & Prior Authorization Information
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  • University Community Care Plan Provider Manual
    • EXHIBIT 1: Request For Continuity of Care
    • EXHIBIT 2: Provider Request for Member Transfer
    • EXHIBIT 3: Community First Authorization List
    • EXHIBIT 4: University Community Care Plan Member ID Card
    • EXHIBIT 5: Texas Standard Prior Authorization Request Form for Health Care Services
    • EXHIBIT 6: Medical Record Review Tool
    • EXHIBIT 7: American Academy of Pediatrics Recommendations For Preventative Pediatric Health Care
    • EXHIBIT 8: CDC Adult Preventative Care Recommendations
    • EXHIBIT 9: Consent to Use Physician Assistant/Nurse Practitioner
    • EXHIBIT 10: Member Education Request Form
    • EXHIBIT 11: CMS-1500 Form and Instruction Table
    • EXHIBIT 12: UB 04 Claim Form and Instructions
    • EXHIBIT 13: Explanation of Payment (EOP)
    • EXHIBIT 14: Suspicious Activity Report (Member)
    • EXHIBIT 15: Suspicious Activity Report (Provider)
    • EXHIBIT 16: Claims Department Appeal Submission Form
    • EXHIBIT 17: Provider Complaint Form
    • University Community Care Plan Provider Manual
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1410 Guadalupe
Ste. #222
San Antonio, TX 78207
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Need help in another language? Community First Insurance Plans has bilingual health care specialists who can assist you over the phone. You can also request any materials on this website in another format, such as large print, or in another language. Simply call Member Services.

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