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.

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Provider News

FirstCare Teaming Up with Palladian Health—Effective 10/17/16

Updated Thursday, September 29, 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 17, 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 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

IMPORTANT—FirstCare Medicare Advantage Plan Changes

Wednesday, September 28, 2016

Our goal is to provide the best health plan solutions for our members while weighing the financial challenges of declining reimbursement and rising costs. It was difficult, but we made the decision to not renew our Medicare Advantage contract with The Center for Medicare & Medicaid Services (CMS) for 2017.
Our Medicare members will remain enrolled in their current FirstCare Advantage (HMO) coverage—and may obtain services—through December 31, 2016. However, they must choose a new plan for their coverage to continue in 2017. They have from October 15, 2016 – February 28, 2017, to make that selection. All FirstCare Advantage (HMO) members have been notified via letter for receipt no later than October 2, 2016. Copies of the letters are attached for your reference:

FirstCare will continue to pay claims for contracted providers in accordance with the contract and our claims filing guidelines.
This change does not impact any of FirstCare’s non-Medicare members or other lines of business. FirstCare remains committed to the communities we serve, as we work with you to play an important role in providing affordable health care coverage to West Texans.
And, as always, we appreciate your support.
If you have questions, please contact FirstCare Advantage (HMO) Customer Service at 1.866.229.4969 (TTY/TDD 1.800.562.5259). Our lines are open daily Oct. 1 - Feb. 14, from 8 a.m. - 8 p.m. From Feb. 15 - Sept. 30, our lines are open from 8 a.m. - 8 p.m. CT, Monday through Friday. You may also email, 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

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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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