CHIP / CHIP Perinatal
The Children’s Health Insurance Program (CHIP) and CHIP Perinatal Program provides low cost services to children, pregnant woman, and unborn children of non-Medicaid eligible women.
CHIP Program
CHIP is a managed care plan for uninsured children in Texas. Our objective is to ensure that CHIP Members access primary care services appropriately and receive services in the most cost-effective setting. Our network comprises physicians, allied and ancillary health care providers, hospitals and other facilities selected to provide quality health care to our CHIP Members. The Primary Care Physician (PCP) is responsible for managing the overall medical care of patients, and coordinating referrals to specialists and inpatient/outpatient facilities.
The PCP is a Community First network provider with one of the following specialties: General Practice, Family Practice, Pediatrics or Internal Medicine, Obstetrics and Gynecology (pregnant women only), Pediatrics, Federally Qualified Health Centers (FQHCs) or Rural Health Clinics (RHCs). In addition, Community First Health Plans CHIP Members can access contracted Advance Practice Nurses, Physician Assistants, and Certified Nurse Midwives practicing under the supervision of a physician for appropriate covered services.
CHIP Perinatal Program
The Children’s Health Insurance Program (CHIP Perinatal) Perinatal Program provides services to unborn children of non-Medicaid eligible women. Unborn children will be eligible from conception and, once enrolled, they will receive 12 months of continuous eligibility.
Provider Training Schedule
To register for training sessions, please call (210) 358-6030 or email nmcfhp@cfhp.com.
Free, online provider education is available and many include Continuing Education credits. Check out the online options offered by Texas Health and Human Services Commission (HHSC).
For additional information about the CHIP and CHIP Perinatal Programs, please visit Health & Human Services using the link below.
PROVIDER EDUCATION WEBINARS
Access our library of resources, forms, and other information available to our Providers.
Community First values each participating provider in our network. This Provider Manual has been designed to provide you with the information you need when treating a CHIP Member. It also contains links to helpful exhibits and forms, information regarding administrative procedures, medical management procedures and programs, and quality improvement programs. This manual is reviewed periodically and may be changed as needed.
Our CHIP Provider Manual and other materials are available in print, free of charge, and mailed within 5 days. Contact your Provider Relations Representative or call 210-358-6294 for a printed copy.
Nurse Advise Hotline
Nurse Advice Line (210) 227-2347 or toll free at 1-800-434-2347
Community First does not require a referral for a Member to see a specialist. Some specialist’s offices may require or prefer to have a referral. Members should ask their PCP to confirm with the specialist if a referral is needed from the PCP to be seen.
If the specialist is not-network, Community First will work to complete a Letter of Agreement (LOA)/Single Case Agreement with the non-network specialist. These LOA/Single Case Agreements can be for one or several visits and lengths of time depending on the medical necessity as determined by Community First.
Any downtime for routine scheduled maintenance for Provider-facing systems are posted to Community First’s website and shared with Community First staff. A toll-free number is provided that is also shared.
For outages and/or unplanned downtime, information will be posted to Community First’s website and appropriate toll-free numbers will be posted and shared with Community First staff.
If you are a Provider and need to reach Community First after hours or on weekends, please call (210) 227-2347.