COVID-19 Provider Resources

How we’re supporting you and your patients during the ongoing health pandemic

Health Confianza, a collaboration between UT Health San AntonioUT San Antonio, and the San Antonio Metropolitan Health District, is providing COVID-19 Health Literacy sessions to share up-to-date information to local providers.

Thank you to our doctors, nurses, clinicians, and health care workers:

Your tireless dedication to your patients and communities during this time is inspiring. As we continue to move through these uncertain times, we’re committed to providing you with the answers and information you need to keep your practice running.

COVID-19 Vaccine: Provider Information

Information regarding the COVID-19 vaccine and its distribution is rapidly evolving. As a Community First Provider, we understand that our Members look to you for information and guidance.

Community First would like to share the following information and resources with our Providers so that you can best serve your patients

Providers should check the DSHS Information For COVID-19 Vaccine Providers as information is subject to change.

Enroll to be a COVID-19 vaccinator

Providers must register through the Texas DSHS Immunization Program Portal to administer and receive COVID-19 vaccines in Texas.

For questions about registering to be a COVID-19 vaccinator, call the DSHS COVID-19 Vaccine Provider hotline at (877) 835-7750, Monday-Friday, 8 am–5 pm or email COVID19VacEnroll@dshs.texas.gov.

Resource: Tips and Tricks for Enrolling in the COVID-19 Vaccine Program

Vaccine Eligibility

All COVID-19 vaccines are authorized for people age 18 and older. The Pfizer vaccine is the only vaccine currently authorized for individuals ages 5 and older.

Summary Document for Interim Clinical Considerations

Booster Shot Eligibility
5/23/22 Update: COVID-19 Vaccine Booster Doses for Children 5 through 11 Years of Age

Pursuant to CDC/ACIP recommendations and the May 23, 2022, Secretarial Directive on Pediatric and Second COVID-19 Vaccine Booster Doses, all providers in the CDC COVID-19 Vaccination Program shall make immediately available and administer a single booster dose of Pfizer-BioNTech COVID-19 vaccine to individuals seeking such a dose as follows:

Children ages 5 through 11 years should receive a single Pfizer-BioNTech COVID-19 vaccine booster dose at least 5 months after completion of a Pfizer-BioNTech COVID-19 vaccine primary series.

5/23/22 Update: Second COVID-19 Vaccine Booster Doses

Pursuant to CDC recommendations and the May 23, 2022, Secretarial Directive on Pediatric and Second COVID-19 Vaccine Booster Doses, all providers in the CDC COVID-19 Vaccination Program shall make immediately available and administer a second age-appropriate booster dose of Pfizer-BioNTech or Moderna COVID-19 vaccine to individuals seeking such a dose as follows:

  • People 12 through 49 years of age who are moderately or severely immunocompromised should receive a second booster dose of an mRNA COVID-19 vaccine at least 4 months after receipt of their previous booster dose. (Note that the Moderna COVID-19 vaccine is authorized only for persons 18 years of age and older.)
  • People 50 years of age and older should receive a second booster dose of an mRNA COVID-19 vaccine at least 4 months after receipt of their previous booster dose.

    CDC Guidance: COVID-19 Vaccination Program Provider Requirements and Support

    COVID-19 Testing

    Health insurance companies are now required to reimburse Americans for eight at-home antigen tests per person a month. If an individual has been directed to undergo COVID-19 testing by their medical provider because of underlying health conditions or other factors, there is no limit on the number of tests covered.

    Community First Members should purchase tests at a network pharmacy counter to ensure that it is processed through their insurance plan properly to avoid out-of-pocket costs.

    If a Member purchases an at-home test from a store or online and is charged for their test, please instruct them to submit a claim to be reimbursed.

    Medicare Reimbursement Claim Form

    Medicaid/CHIP/UCCP/UFCP Reimbursement Claim Form

     

    Vaccine Safety

    Providers can play an important role in helping the CDC and federal partners monitor the safety of COVID-19 vaccines.

    New safety systems have been added for COVID-19 vaccines, including the following new CDC initiatives:

    Vaccine Coverage and Reimbursement

    Similar to other COVID-19 services, the vaccines will be offered at no cost to patients.

    To prepare for vaccine administration, the Centers for Medicare and Medicaid (CMS) have published billing guidance for Medicaid (STAR and STAR Kids), Children’s Health Insurance Program (CHIP), and Medicare providers.

    Visit Community First HHSC News for other important HHSC updates regarding the vaccine.

    Booster Shots

    DC now recommends booster shots at 5 months after the completion of the primary series of Pfizer-BioNTech COVID-19 vaccine for those aged 5 and older.

    Summary of recent changes (last updated May 20, 2022):
    • New guidance for use of a Pfizer-BioNTech COVID-19 Vaccine booster dose in children ages 5–11 years
      • Updated guidance for people who are moderately or severely immunocompromised and are treated with B-cell-depleting therapies
      • Clarification of COVID-19 vaccination guidance for multisystem inflammatory syndrome in children (MIS-C) and adults (MIS-A)
      • Updated guidance for primary series vaccination after SARS-CoV-2 infection
      • Updated guidance that the following people should receive a second COVID-19 booster dose:
        • People ages 12 years and older who are moderately or severely immunocompromised
        • People ages 50 years and older

       Interim Clinical Considerations for COVID-19 Booster Shots

      Access COVID-19 billing and coding resources you need to help treat Community First Members.

      Latest Provider Updates

      Get the latest COVID-19 Provider updates.

      Can’t find what you need?

      Please call the Provider Hotline at 210-358-6030 from 8:30 a.m. to 5 p.m., Monday – Friday.  

      If you are a Provider and need to reach Community First after hours or on weekends, please call (210) 227-2347.

      We have launched a new secure portal for both Members and Providers! You will need to create a new account to access it. Register now!

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