CHIP Complaints and Appeals Process
When you have a problem, call Customer Service at 1-877-639-2447. They can provide assistance and may be able to resolve your problem while you are on the phone or within days of your call.
This document contains information on how to make a complaint or file an appeal if you are a CHIP member.
You can report a problem over the phone or in writing and we will respond within 5 days. If you tell us the problem by phone, we will send you a one page form to complete and return. If you inform us of a problem, we will write you back with the date we received your letter. This date is important because we have thirty (30) days to make a decision on your complaint.
If you are not satisfied with the outcome, you can appeal. You have the right to appeal at any time during this process. You have only 180 days from the date on the letter to file an appeal. If you do not file your appeal within 180 days, you forfeit the right to appeal. The appeal is not a court of law.
You may request an appeal by calling Customer Service or the Department of Insurance at 1-800-252-3439 or by writing to:
Texas Department of Insurance
PO Box 149104
Austin, TX 78714-9104
Fax: 512-475 1771
Website:
www.tdi.texas.gov
Email:
consumerprotection@tdi.state.tx.us
If FirstCare informs you that your child received services that were not medically necessary and you do not agree, you are entitled to request an independent review.
If you have questions, call Customer Service at 1-877-639-2447.