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1 mar 2024 · You must follow the rules and regulations for prior authorizations that are published in the Texas Medicaid Provider Procedures Manual. You can submit prior authorizations through PA on the Portal and on paper.
Authorization phone assistance is available on weekdays from 8am – 5pm in all time zones in Texas. To access the phone numbers for inpatient notification and prior authorization for each applicable service type, please refer to the FAX, PHONE, AND SECURE PORTAL DIRECTORY dropdown on this webpage. Fax Requests
STAR and CHIP Service Coordination phone number: 1-877-214-5630 (TTY 711) STAR Kids Service Coordination phone number: 1-877-301-4394 (TTY 711) If your provider needs to contact us, he or she may call the Provider Service Hotline number: 1-877-784-6802 .
Provider Assistance with Pharmacy Prior Authorizations: Phone: 210-227-2347; Toll-Free: 1-800-434-2347; Hours of Operation: Monday-Friday from 8:30 a.m. to 5 p.m. For further assistance with specific plans, please refer to our Provider Quick reference Guide which includes helpful prior authorization phone and fax numbers.
For prior authorization of medications covered by the VDP, contact the contracted PBM at 1-866-768-7147. For information regarding contracting as a network pharmacy please visit the Express Scripts website.
The Children's Health Insurance Program (CHIP) covers children in families that earn too much money to qualify for Medicaid but can’t afford to buy private insurance. If you’re new to CHIP, you’ll choose a health plan for your child from the ones available in your service area (PDF) .
If you have any questions regarding pharmacy prior authorizations, contact Pharmacy Member Services, available 24/7, using the information below: CHIP, STAR, STAR+PLUS: 833-235-2022 (TTY 711) STAR Kids: 833-370-7463 (TTY 711)
