Provider Forms
- Request For Continuity of Care
- Provider Request for Member Transfer
- University Community Care Plan Member ID Card
- Texas Standard Prior Authorization Request Form for Health Care Services
- Medical Record Review Tool
- American Academy of Pediatrics Recommendations For Preventative Pediatric Health Care
- CDC Adult Preventative Care Recommendations
- Consent to Use Physician Assistant/Nurse Practitioner
- Member Education Request Form
- CMS-1500 Form and Instruction Table
- UB 04 Claim Form and Instructions
- Explanation of Payment (EOP)
- Suspicious Activity Report (Member)
- Suspicious Activity Report (Provider)
- Claims Department Appeal Submission Form
- Provider Complaint Form
- Claims Appeal Form
- Pre-Authorization Exemption FAQs
- Community First Insurance Plans Compliance Plan 2023
- Provider Information Change Form