Provider News
Modifier 25: Correct Use and Coding Guidance for Preventive and Acute Care Services
Community First Health Plans is providing guidance on the appropriate use of Modifier 25 when reporting evaluation and management (E/M) services performed on the same date as a preventive medical visit. Proper use of Modifier 25 supports accurate claims processing,...
Modifier 26: Correct Use and Coding Guidance for Diagnostic Services (Professional Component)
Community First Health Plans is providing guidance on the appropriate use of Modifier 26 (Professional Component) when billing for diagnostic services. Proper use of Modifier 26 supports accurate claims processing, compliance with CMS billing guidelines, and reduces...
Important: New TMHP Login Process for All Texas Medicaid Providers – Action Required
Community First Health Plans is sharing information regarding TMHP’s implementation of a new login platform, TMHP IAMOnline, which will serve as the single sign‑on entry point for Texas Medicaid Provider portal applications. What Providers Need to Do: Follow the...
Reminder: Prohibition of Balance Billing for Community First Medicaid Members
As a participating Provider with Community First Health Plans, it is crucial to adhere to our policies regarding Member billing. This notice serves as a reminder of your obligations and our Members’ rights, particularly concerning balance billing practices....
Servicing Facility Location Reporting on Professional Claims (837P): Correct Use and Coding Guidance
Community First Health Plans is providing guidance on the correct reporting of Servicing Facility Location information on professional claims submitted using the 837P electronic claim format. Accurate reporting of the servicing facility is required when services are...
IMPORTANT REMINDER: Upcoming Policy Changes Related to Improvements in Claims Processing
Effective August 3, Community First Health Plans will enhance the existing claims processing program to improve the overall accuracy of claim processing in partnership with Cotiviti. We want to share this information in advance, so you are prepared for the upcoming...