Frequently Asked Questions
How do I obtain Reimbursement Information?
Contracted Providers: Please contact Provider Relations at 713-338-4801 or firstname.lastname@example.org. Important Note: Providers affiliated with one of the following groups must contact the group for instructions regarding reimbursement related questions:
- MD Anderson
- Take Care Health
- Texas Children's Pediatrics
- Texas Oncology
- UT Physicians
- Vision Source
Please contact Customer Service at
713-338-6535 or 888-642-5040 for Self Funded Groups
713-338-4683 or 888-594-0671 for Insured Groups
844-550-6886 for Medicare Advantage HMO
844-550-6896 for Medicare Advantage PPO
High Call Volume
Our provider services call center is experiencing longer than usual wait times due to high call volumes during this busy time of year. Your calls are important to us and we are working diligently to respond to each in a timely manner. In order to accommodate your inquiries, our provider call center will remain open until 8:00pm CST through Friday, January 15th.
Calls requesting eligibility and benefit verification are our top priority and will be responded to within one business day. To submit a prior authorization, download the form from our Resource Center and fax your completed version to (713) 338-6494.
All other requests, such as claims inquiries, will be handed in the order received and responded to as quickly as possible, and within 4-5 business days.
Claims Status Inquiries can be emailed directly to email@example.com. For multiple claim status requests, providers can download our Claim Status Request Form.
If providers would like to appeal a prior adverse determination (for pre-authorization or a denied claim), you can download the Appeal Reference Form and send it directly to Health Solutions A&G.
Finally, our online portal is available to verify eligibility or claim status. If providers are not yet registered, download our Provider Online Access Form and email a completed version to firstname.lastname@example.org.
Providers experiencing difficulties getting in or who may have forgotten their user IDs/passwords may send an email to email@example.com for assistance.
Where do I mail my claims?
Mail your claims to:
PO Box 660303
Dallas, TX 75266-0303
How do I obtain an online account (user ID and password)?
Visit the Resource Center and click on “Provider
Online Access Form” under the "Provider Forms" section. Fill out the form and fax to (713) 338-4118 or send via email to firstname.lastname@example.org . A representative will contact you with your login information.
How do I view my members online?
After logging in with your user ID and password, select “My Members” to access your current roster.
How do I see the eligibility status of a patient?
After logging in with your user ID and password, select "Check Eligibility" from the menu choices in the left-hand
menu. Enter the patient's demographic information to view information about eligibility, a printable summary of
their plan benefits, and the actual utilizations the patient has had to date.
How do I unlock my online account?
Send an email to email@example.com. A representative will contact you with your login information.
How do I join the network?
If you would like to join our provider network, please download and fill out the Request for Participation Form and email to our contracting representatives at firstname.lastname@example.org.