As a Member, you have the right to ask for an appeal if you disagree with Community Health Choice’s answer or if you believe we made a mistake in denial of your requested medical services. You may ask for an appeal or call Community Health Choice Member Services to help in writing your appeal for submission to the Medical Appeals Department. Call Community Health Choice Member Services at 1.888.435.2850 or send your appeal to:
Community Health Choice, Inc.
Attention: Medical Affairs-Medical Appeals Department
4888 Loop Central Drive, Suite. 600
Houston, TX 77081
Phone: 713.295.2300 or toll-free at 1.888.435.2850 or TTY 7-1-1
Fax: 713.295.7033
You may mail your Behavioral Health appeal to the address below:
Community Health Choice Texas, Inc.
Attention: Medical Affairs-BH Appeals
P.O. Box 1411
Houston, TX 77230
713.295.2300 or toll-free at 1.888.435.2850 or TTY 7-1-1
Fax: 713.576.0394/ Attention: BH Appeals Coordinator
For current authorized services to continue, you must file the appeal on or before the later of:
- 10 calendar days after the date we mail you our notice of the Action
- The date the proposed Action will be effective.
Can I ask for a State Fair Hearing?
If you, as a Member of the health plan, disagree with the health plan’s decision, you have the right to ask for a State Fair Hearing.
You may name someone to represent you by writing a letter to the health plan telling them the name of the person you want to represent you. A provider may be your representative. If you want to challenge a decision made by your health plan, you or your representative must ask for the State Fair Hearing within 120 days of the date on the health plan’s letter with the decision. If you do not ask for the State Fair Hearing within 120 days, you may lose your right to a State Fair Hearing.
To ask for a State Fair Hearing, you or your representative should either send a letter to the health plan at
Community Health Choice Texas, Inc.
Medical Appeals Department-Medical Affairs
4888 Loop Central Drive, Suite. 600
Houston, TX 77081
Phone: 713.295.2300 or toll-free at 1.888.435.2850 or TTY at 7-1-1
Fax: 713.295.7033
If you ask for a State Fair Hearing within 10 days from the time you get the hearing notice from the health plan, you have the right to keep getting any service the health plan denied, at least until the final hearing decision is made. If you do not request a State Fair Hearing within 10 days from the time you get the hearing notice, the service the health plan denied will be stopped.