Forms & Reference Guides

View or Download Forms, Manuals, and Reference Guides

In this section of the Provider Resource Center you can download the latest forms and guidelines including the Provider Manual and Quick Reference Guides for each plan that Community Health Choice offers.

Forms and Guides by Plan:

• STAR/CHIP
• STAR+PLUS
• Medicare
• Health Insurance Marketplace

STAR/CHIP Provider Profile

• Member Reassignment Form
• Member Education Form
• Specialist Consultant Form

Prior Authorizations

• Provider Authorization Information (including PA Catalog)
• Texas Standard Authorization Form
• Community’s Preferred Authorization Form

Allergy Skin Testing and Allergy Therapy Assessment Tool

Maternity Case Management Program

• ProgenyHealth effective October 25, 2023
• ProgenyHealth® Overview
• ProgenyHealth® FAQ
• ProgenyHealth® Maternity Case Management Program
• Provider Overview Flyer
• Member Pregnancy Flyer – English
• Member Pregnancy Flyer – Spanish
• Member Postpartum Flyer – English
• Member Postpartum Flyer – Spanish
• Pregnancy Referral Program Form

Member Mammogram Guide:

Manuals

• Medicaid/CHIP Provider Manual
• Texas Medicaid Uniform Managed Care Manual
• Texas Medicaid Provider Procedures Manual
• TMHP Manual

MAXIMUS’ THSteps Form

• THSteps Provider Outreach Referral Form Instructions
• THSteps Provider Outreach Referral Form

Links

• Texas Health and Human Services Commission
• Texas Medicaid & Healthcare Partnership
• Texas Medicaid/CHIP Vendor Drug Program
• Annual THSteps Provider Training

Quick Reference Guides

• CHIP Perinatal Quick Reference Guide (Effective 03/25/2024)
• CHIP Quick Reference Guide (Effective 03/25/2024)
• HEDIS Quick Reference Guide
• THSteps Quick Reference Guide
• STAR Quick Reference Guide (Effective 03/25/2024)
• THSteps Medical Checkup Billing Procedure Codes (Revised 02/01/2023)
• THSteps Medical Checkup Periodicity Schedule
• Community’s THSteps Resource Guide
• Member Safety Plan
• Patient decision aids (PDAs) | Washington State Health Care Authority

Synagis Program

• Synagis: Texas Medicaid STAR/CHIP
• Synagis Prior Authorization Request Form
• Synagis: Texas Vendor Drug Program

Clinical Practice Guidelines

Provider Complaints

Provider Medical Appeals

Provider Claims Payment Appeal

Member Requests

STAR+PLUS Provider Forms

Provider Manuals

• Provider Manual
• Provider Nursing Facility Manual

Provider Complaints

Provider Medical Appeal

Attendant Compensation Rate Enhancement Program (ACEP)

Provider Claims Payment Appeal

• Provider Claims Payment Appeal Information
• Provider Claims Payment Appeal Form

Medicare Provider Forms

Provider Manuals

• Medicare Provider Manual
• Provider Orientation
• Model of Care for Out of Network Providers
• Care Transitions & Continuity of Care Training for Providers, Office Staff, and FDRs
• Cultural Competency

Prior Authorizations

• Provider Authorization Information (including PA Catalog)
• Texas Standard Authorization Form
• Community’s Preferred Authorization Form

Quick Reference Guides

• Quick Reference Guide
• Waiver of Liability

Allergy Skin Testing and Allergy Therapy Assessment Tool

Clinical Practice Guidelines

Provider Medical Appeals

Provider Claims Payment Appeal

Member Requests

Health Insurance Marketplace Provider Forms

Provider Manuals

• Marketplace Provider Manual
• Quick Reference Guide (Effective 03/25/24)
• HEDIS Quick Reference Guide
• Top 10 Suggestions for Documentation
• Chasing the Chart
• Clinical Practice Guidelines Clinical and Preventive

Allergy Skin Testing and Allergy Therapy Assessment Tool

Provider Medical Appeals

Provider Claims Payment Appeal

Prior Authorizations

• Provider Authorization Information (including PA Catalog)
• Texas Standard Authorization Form
• Community’s Preferred Authorization Form

Maternity Case Management Program

• ProgenyHealth effective October 25, 2023
• ProgenyHealth® Overview
• ProgenyHealth® FAQ
• ProgenyHealth® Maternity Case Management Program
• Provider Overview Flyer
• Member Pregnancy Flyer – English
• Member Pregnancy Flyer – Spanish
• Member Postpartum Flyer – English
• Member Postpartum Flyer – Spanish
• Pregnancy Referral Program Form

Member Mammogram Guide:

Member Requests

Member Appeals

• Member Appeal form – English
• Member Appeal form – Spanish