Provider Appeals
Contact Information:
Claim Appeals may be submitted via:
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- DHP Provider Portal
- Email: DHPPortalappeals@dchstx.org,
- Fax: 361-808-2776
You may also submit your Claim Appeal by mail:
PO Box 3668
Corpus Christi, TX 78463
Resources & Information
To verify member eligibility, benefits, prior authorizations, claim questions or Provider Relations, contact:
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Provider Services for Hidalgo Service Area (1-855-425-3247)
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Provider Services for Nueces Service Area (1-877-324-3627)
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Preauthorization and Referrals (CHIP/STAR/STAR Kids) – Utilization Management Department (1-877-455-1053; FAX: 1-866-741-5650)
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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.
PCP Virtual Lecture Series
Join our Continued Medical Education (CME) virtual series on April 15th, 2021 at 6:30p.m. CDT.
DHP PCP Incentives, Provider Advisory Comments, Q&A. Viewed only on WebEx.
Provider Complaints
Contact Information
Driscoll Health Plan
ATTN: Performance Excellence Team
4525 Ayers Street
Corpus Christi, Texas 78415
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
Helpful Links
Electronic Visit Verification (EVV) HHSC – Module 2
Driscoll Health Plan-Therapy Guide
Request to Credential New Provider to Exisiting Group
Provider Relations Contact Information
Texas Standardized Credentialing Application
Texas Standardized Credentialing Application Addendum
Expedited Credentialing Request
Member Rights and Responsibilities
Texas Medicaid & Healthcare Partnership
Texas Health and Human Services Commission
Texas Medicaid and CHIP Vendor Drug Program
Texas Health Steps Provider Information
Texas Standard Prior Authorization Request Form for Health Care Services
Texas Standard Prior Authorization Request Form for Prescription Drug Benefits
Provider News Updates
Alert: EVV Tool Kit – Module 2 Now Available
Implementation of the AIM Program begins in Texas
New Systems, new information, a new way of looking at care
Spring is here, and bringing CME opportunities
Benefits for prevention of Zika to become permanently covered
Implementation of Preferred Drug List Delayed
State Implemented CVO for Credentialing/Re-credentialing of Providers
Behavioral Health Authorization Requirements associated with developmental screening
Cultural Competency and Sensitivity
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.
Provider Advisory Board
At Driscoll Health Plan, we value your opinion. For meeting times, dates and locations, please contact Cindy McMahon at 361-694-4881 or Cindy.McMahon@dchstx.org.
Texas Vendor Drug Program - Preferred Drug List
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 |