Administrative Services

Let Us Handle That for You

Thinking about self-funding your company’s health care coverage? Outsource the management of your self-funded health care programs to us. Our experienced third party administration (TPA) branch can take that burden off of you, so you can focus on your business.

FirstCare Administration Services provides:

Detailed design and administration of your customized benefit plan
Responsive and friendly Texas-based customer service
Accurate adjudication of medical claims
Reporting, when you need it
Access to multiple reinsurance carriers to provide excess loss protections for high-dollar claims
Pharmacy benefits through Navitus
Support for you, Monday through Friday, 8 a.m. - 5 p.m. CT
- 1-888-249-7366 (toll free)
- 1-877-878-8422 (fax)

Resources

Find a Provider Service Area Map

Ask the Pharmacist

Have a question about a specific drug, or a drug benefit in your plan? Email our Pharmacist for the answers you need!

Talk to a Nurse—Nurse24™

Need care advice? Should you see a doctor? Get the info you need today! FirstCare members can talk to a nurse 24/7 by calling 1-855-828-1013 to get answers 24 hours a day, 7 days a week! TTY users can call 7-1-1 or 1-800-955-8771. Voice communication is available at 1-800-955-8770.

Utilization Management

Ever wonder how we decide what services to authorize for our members? Our utilization management (UM) decisions are based on medical evidence and consensus of health care professionals. For more details, click here.

The National Committee for Quality Assurance (NCQA) awarded FirstCare a Commendable Status (Medicaid HMO, 09/2018) & an Accredited Status (Commercial and Marketplace HMO, recertified 02/2018)—reflecting our continuous work to fulfill NCQA requirements for consumer protection & quality improvement.