Please contact us if you have questions or need assistance:

Hours
Monday – Friday (excluding State-approved holidays),
8:00 a.m. to 5:00 p.m.

Phone
Local: 713.295.6704
Toll-Free 1.855.315.5386

TDD Number for Hearing Impaired
7-1-1

Review a list of the covered services that require prior authorization.

View the requirements for posting Prior Authorizations.

Healthcare providers are responsible for submitting prior authorization requests. These can be submitted by phone, fax or online. Your doctor can also get more information by visiting Community Health Choice’s Prior Authorizations webpage.

The timeframes for responding to prior authorization requests are listed below.

Physical Health Services, Supplies, Equipment, Behavioral Health Services, Clinician Administered Drugs (CAD)

Pharmacy

Community Health Choice will deny a claim if your provider does not obtain an authorization before providing services to you.  You will not be billed for payments for such services, unless services are not a benefit or as specified in your benefit plan.

Except for emergency services, post-stabilization services, and services provided to you during an approved inpatient admission, all services from an out-of-network provider must be prior authorized. Claims for services from out-of-network providers that are not approved before the service is given will be denied. You may receive a bill from the provider for those services.