Providers

Why work with FirstCare?

Like you, we are deeply committed to doing the right thing for the health of our communities. FirstCare is Texas-based and provider-owned, so we know what it means to deliver quality care, right here. We want doctors to be in charge of patient care. We’ll do everything we can to help you achieve better patient outcomes.
 
Partnering with FirstCare can connect you with more than 1,200 contracted facilities, including 115 hospitals, and more than 12,000 other contracted providers. Our strong local ties can generate favorable new business — from commercial to government-employed patients — all at competitive, profitable rates. FirstCare has tremendous expertise in compliance, administration, and processing for STAR, CHIP, Medicare and FEHB programs. And we do it all with high ease of use, high reliability and low administrative hassle.

Learn More About Becoming a Provider >
 



Provider News

FirstCare Teaming Up with Palladian Health—Effective 10/03/16

Thurssday, September 1, 2016

As mentioned in FirstCare’s fax communication to providers on August 31, 2016, we have contracted with Palladian Health—a spinal care management company—to revise and enhance FirstCare’s authorization process for spinal care-related services, as well as adult physical therapy (PT) and adult occupational therapy (OT). Effective October 3, 2016, Palladian Health experts will begin reviewing requests for medical necessity authorizations and provide an opinion on medical necessity to FirstCare. Our Medical Management Team will review the Palladian’s recommendations, then approve or deny the request.

Authorization Requests—Online or Fax

  • Log on to the Palladian web portal by logging on to the FirstCare Providers page and following the steps to request an authorization. Once the service code is entered, our web portal transfers the end user to the Palladian web portal.
  • To submit requests via fax, there are newly required forms which must be completed and submitted with the request. Each request should be sent to FirstCare at 1.800.248.1852 and will require a Patient Outcomes-Clinical Information Form and one of the following preauthorization checklists:
    • Neurostimulator & Pain Pump Authorization Checklist
    • PT/OT Treatment Form
    • Spinal Injections Authorization Checklist
    • Spinal Surgery Authorization Checklist
See the FirstCare Providers page for more updates and information as the launch date approaches.

If you have any questions, please email the FirstCare Provider Relations team at provider_relations@firstcare.com or contact your FirstCare Provider Relations representative at the number below:
  • Abilene area:               1.325.670.3525
  • Amarillo area:              1.800.239.5650
  • Lubbock area:             1.806.784.4380
  • All other areas:            1.800.431.7737

FirstCare Government Programs Provider Workshops—09/13/16 & 09/14/16

Thurssday, September 1, 2016

FirstCare is proud to present our 2016 series of online provider workshops for our Government Programs providers.
 
Join us for one of our online workshops on Tuesday, September 13, or Wednesday, September 14, 2016. Click here for more information on these upcoming sessions.

If you have any questions, please email the FirstCare Provider Relations team at provider_relations@firstcare.com or contact your FirstCare Provider Relations representative at the number below:

  • Abilene area:               1.325.670.3525
  • Amarillo area:              1.800.239.5650
  • Lubbock area:             1.806.784.4380
  • All other areas:            1.800.431.7737

View all provider news >

Resources

Care Management Services

Authorization Requirements
FirstCare Authorization Requirements Matrix Updated 9/14/2016 Spinal Care and Rehabilitation Authorization Requests (Includes other new codes too) Effective 10/1/2016 FirstCare Medical Pharmacy Authorization Requirements Updated 9/14/2016 FirstCare DME Authorization Requirements Updated 9/14/2016 FirstCare Behavioral Health Authorization Requirements Effective 8/25/2016 Providence (SmartHealth) Pre-Certification List Effective 1/1/2016


The National Committee for Quality Assurance (NCQA) has awarded an accreditation status of Accredited for service and clinical quality that meet the basic requirements of NCQA's rigorous standards for consumer protection and quality improvement.

You are leaving FirstCare Advantage (HMO)'s Medicare web pages.

Click Continue to proceed or Cancel to stay.

Continue Cancel

Send to a Friend

* Required field

Captcha The math problem above is intended to reduce spam.