Providers

Resources & Information

To verify member eligibility, benefits, prior authorizations, claim questions or Provider Relations, contact:

  • Provider Services for Hidalgo Service Area (1-855-425-3247)

  • Provider Services for Nueces Service Area (1-877-324-3627)

  • Preauthorization and Referrals (CHIP/STAR/STAR Kids) – Utilization Management Department (1-877-455-1053; FAX: 1-866-741-5650)

  • Prior authorization for PDN, PCS, and LTSS services (1-844-376-5437 /Fax: 1-844-381-5437)


Prior Authorization

Our tool contains information about our Prior Authorization process and when you will need to obtain one. To access this information, we provided a wide range of categories and a searchable tool that allows you to enter any CPT/HCPCS code.



Contact Information

Driscoll Health Plan

ATTN: Performance Excellence Team

615 N. Upper Broadway, Suite 200-F

Corpus Christi, Texas 78401-0764

Phone Number: 1-877-220-6376 (Nueces SA) or 1-855-425-3247 (Hidalgo SA)

Fax Number: 361-808-2725

Email: DHP_QM_Complaints@dchstx.org

 

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

If you can get on the internet, you can send your complaint in an email to HPM_Complaints@hhsc.state.tx.us

Contact Information:

Claim Appeals may be submitted via:

ATTN: Claims Appeals Department

615 N. Upper Broadway, Suite 1800

Corpus Christi, Texas 78401-0764

 

 

Driscoll Health Plan places great emphasis on the wellness of its Members. A large part of quality health care delivery is treating the whole patient and not just the medical condition. Sensitivity to differing cultural influences, beliefs and backgrounds can improve a provider’s relationship with patients and in the long run the health and wellness of the patients themselves. DHP encourages all providers to be sensitive to varying cultures in the community.

For more information, please visit the Texas Health Steps website.

Texas Vendor Drug Program Most Notable Preferred Drug List Changes Effective 7/30/20:

ADDERALL XR NON PREFERRED
AMPHETAMINE/DEXTROAMPHETAMINE XR PREFERRED
LYRICA CAP NON PREFERRED
PREGABALIN CAP PREFFERED
TAMIFLU CAP NON PREFERRED
OSELTAMIVIR CAP PREFERRED
JORNAY PM NON PREFERRED
METHYLPHENIDATE ER TAB PREFERRED