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 >

 

 

Corporate Medical Advisory Committee (CMAC)

The Corporate Medical Advisory Committee (CMAC) develops, reviews and approves clinical programs and guidelines, studies, and other clinical activities related to the health care services provided to FirstCare members.

 



Provider News

FirstCare PPO Network Name Change Update

Tuesday, January 3, 2017

Effective January 1, 2017, the network associated with our PPO plan has a new name--FirstCare Access PPO Network. The change to the network is in name only.
 
Please note that with this network name change, upon plan renewal, FirstCare PPO members will receive new ID cards showing FirstCare Access PPO Network and PHCS wrap-network information.
 
To view the providers included in the FirstCare Access PPO Network, visit FirstCare.com/Find-A-Provider and click on the FirstCare Access PPO Network link.
 
If you have any questions, please contact our Customer Service Team at 1.800.240.3270 (Monday through Friday; 8 a.m. to 5 p.m. CT) or cservice@firstcare.com.
 
We look forward to continuing to serve you in 2017 and beyond. 

For more information, please email your provider relations representative at Provider_Relations@firstcare.com or call 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 HMO Network Name Change Update

Tuesday, December 6, 2016

At FirstCare Health Plans, our goal is to ensure that providers are well-informed with changes made to our network.  FirstCare has recently made a change to the name to the FirstCare HMO Network. 
 
This network is now identified as the “FirstCare Select Plus HMO” Network.   

This update is solely a change in name to the network formerly known as FC HMO.  
 
Beginning in January 2017, any FirstCare members impacted by this change will receive new ID Cards showing this updated network information.
 
Lastly, we recognize a need for clarification between the FirstCare Select Plus HMO Network and the FirstCare Select HMO Network and have included network definitions below:


  • FirstCare Select Plus HMO - A comprehensive HMO provider network with no carve outs; identical to the network formerly identified as FC HMO.  

  • FirstCare Select HMO - This network includes Covenant and primarily its affiliated physicians; excluding UMC and most Texas Tech physicians.       

For more information, please email your provider relations representative at Provider_Relations@firstcare.com or call 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 >

We're here to help.

Our Provider Relations Team is here for you. If you have questions, please email Provider_Relations@FirstCare.com, or contact your 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

Resources

Care Management Services

Authorization Requirements
FirstCare Authorization Requirements Matrix Updated 1/5/2017 FirstCare Medical Pharmacy Authorization Requirements Updated 1/12/2017 FirstCare DME Authorization Requirements Updated 1/12/2017 FirstCare Behavioral Health Authorization Requirements Effective 1/12/2017 
Referrals & Case Management
Making Referrals & Working with FirstCare Case Management Updated 1/11/2017


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.

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