Appeal submissions must be received by DHP within one hundred and twenty (120) days from the Explanation of Payment (EOP) date. DHP will process the appeal and respond in writing, and/or or adjust any appropriate claim(s), within thirty (30) days from the receipt of the appeal. All administrative claim appeals must be finalized within twenty-four (24) months from the date of service.
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
Contact Information:
Nueces SA: 1-877-324-3627
Hidalgo SA: 1-855-425-3247
Contact Information:
Driscoll Health Plan – Quality Management Department
ATTN: Performance Excellence Team
4525 Ayers Street
Corpus Christi, Texas 78415
Phone Number:
Nueces SA: 1-877-220-6376
Hidalgo SA: 1-855-425-3247
Fax Number:
1-361-808-2725
Email:
[email protected]
Provider Portal:
DHP Provider Portal
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]
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 InformationPlease contact our representatives for support with member eligibility, benefits, prior authorizations, claims or other provider services.
