Welcome to our provider resources hub. Here, healthcare professionals will find a range of tools and information to help streamline excellent patient care.
Please log in to your portal using the below link. To gain exclusive access for your staff, download and complete the Provider Portal Sign-Up form.
Claim Appeals may be submitted via:
Email: [email protected]
Fax: 1-361-808-2776
Mail:
Driscoll Health Plan
ATTN: Claims Appeal Department
PO Box 3668
Corpus Christi, TX 78463-3668
Once you have gone through the Driscoll Complaint Process, and you are not pleased with the response, you may file your complaint directly to the Health and Human Services Commission (HHSC) by calling toll-free 1-866-566-8989. If you would like to make your complaint in writing, please send it to the following address:
Texas Health and Human Services Commission
Health Plan Operations – H-320
ATTN: Resolution Services
P.O. Box 85200
Austin, TX 78708-5200
Email: [email protected]
DHP looks forward to working with you!
To contract and credential with Driscoll Health Plan, please complete the following form and email: [email protected]. Complete this form for all practices or facility locations.
Upon receipt of this request form, DHP will notify Verysis (CVO) to start the credentialing process with your completed credentialing application on CAQH or Availity.
Ensure all information in CAQH or Availity is updated and required documents are current. Please note that providers must be enrolled in Texas Medicaid and have an active NPI before submission of this request.
To Providers: Please update your enrollment and demographic information with TMHP (Texas Medicaid Healthcare Partnership). TMHP is HHSC’s provider enrollment administrator and serves as the authoritative source for HHSC Providers’ enrollment and demographic information. Once you update your enrollment and demographic information with TMHP, your data will be reconciled with the demographic information on file with the MCOs.
To make updates to your current enrollment (e.g., new practice locations or change of ownership updates), please access the web page titled “Provider Enrollment on the Portal A Step-by-Step Guide”
For instructions on how to make other demographic updates to your current enrollment, please access the web page titled “Provider Enrollment and Management System (PEMS)” . Otherwise, you can contact TMHP directly at 800-925-9126 for assistance.
Target Audience: Healthcare professionals who care for children, including community and hospital-based physicians, physician assistants, allied healthcare providers, residents, and medical students
CME Quarterly Meetings FlyerTarget Audience: Non-clinical healthcare professionals who offer administrative support to provider offices including office managers, medical assistants, referral clerks, and front office specialists
Driscoll Health Plan (DHP) fosters an environment of care that acknowledges and respects the culture, language, beliefs, and health literacy of Members and their families. DHP recognizes that these factors affect the health and wellbeing of our members, and strives to ensure that its services meet the challenging needs of an increasingly culturally and linguistically diverse populations, advance health equity among its members and achieve quality outcomes.
DHP will ensure the effective delivery of services in a manner that respects Members linguistic needs, diverse cultural, racial and ethnic backgrounds, religion and religious preference(s), disabilities, and gender and preferred gender. DHP will monitor and assess member needs through the direct and indirect data collected on its membership, and ensures that Providers and Staff appreciate the customs, values, beliefs and abilities of its membership in the subsequent delivery of care and services.
DHP is committed to identifying and addressing health disparities among our Members and actively works with community resources to reduce inequalities in healthcare delivery caused by a lack of awareness or understanding of cultural and language differences, gender identity, and social and economic disparities. DHP partners with several community organizations that assist us in delivering health care messages to our members within hidden communities who are often underserved by community services and public infrastructure. DHP participates in and sponsors numerous programs to benefit these communities, such as providing community health screenings.
At Driscoll Health Plan, we value your opinion. For meeting times, dates, and locations, please contact Provider Relations at 956-632-8308 or [email protected].
Please contact our representatives for support with member eligibility, benefits, prior authorizations, claims or other provider services.
The vendor drug program manages the state Medicaid and CHIP formularies. The website is a great resource to determine if a medication is formulary or to determine which MCOs have implemented a prior authorization.
Texas Health & Human Services News Texas Health Steps Provider Information
