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  • Provider Manuals
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STAR Kids Provider Manual

  • Community First STAR Kids Provider Manual

  • EXHIBIT 1: Request for Continuity/Transition of Care

  • EXHIBIT 10: Psychological Testing Request Form

  • EXHIBIT 11: Member Education Request Form

  • EXHIBIT 12: Medical Record Review Tool

  • EXHIBIT 13: Member/Client Acknowledgement Statement

  • EXHIBIT 14: Preventive Services for Adults

  • EXHIBIT 15: Consent to Use Physician Assistant/Nurse Practitioner

  • EXHIBIT 16: CMS-1500 Blank Paper Claim Form and Instructions

  • EXHIBIT 17: UB 04 Claim Form and Instructions

  • EXHIBIT 18: Private Pay Agreement

  • EXHIBIT 19: Explanation of Payment – Sample

  • EXHIBIT 2: Your Texas Benefits Medicaid Care

  • EXHIBIT 20: Provider Complaint Form

  • EXHIBIT 21: Claims Appeal Submission Form

  • EXHIBIT 22: Medicaid Eligibility Verification Form (H 1027-A)

  • EXHIBIT 23: Current Immunization Schedule for Pediatrics

  • EXHIBIT 24: Blood Lead Screening and Testing Guidelines

  • EXHIBIT 25: Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form

  • EXHIBIT 26: Community First Provider Billing Guidelines

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Categories

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MEDICAID/CHIP ALERT!

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Visit RenewMyTexasBenefits.com to learn more.

Need help in another language? Community First Health 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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