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
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.
