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    5. Health Services Department

    6. Alberto N. Hawkins Settlement Update:

    7. Phototherapy Changes (In-Home)

    15. Member Services Department

    16. Texas Health Steps Exams How do you know when a member is due for a THSteps exam: Their 3087 will state that they are due Member’s due are listed on your Provider Roster Call El Paso First to verify if the member is due for a THSteps exam at (915) 532-3778 or 1-877-532-3778

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    19. Texas Health Steps Exams How do you know when a member is due for a THSteps exam: Their 3087 will state that they are due Member’s due are listed on your Provider Roster Call El Paso First to verify if the member is due for a THSteps exam. (915) 532-3778 or 1-877-532-3778

    20. 3087 Form (Managed Care Medicaid) – Texas Health Steps Exams

    21. 3087 Form (Traditional Medicaid) – Texas Health Steps Exams

    22. STAR Provider Roster That Includes When Texas Heath Steps Medical Exams Are Due

    23. Texas Health Steps Exams El Paso First provides: Assistance to the member to schedule a THSteps exam with their PCP. Accelerated THSteps medical services for migrant members Transportation arrangements for members that are due a THSteps exam (Taxi rides) Telephone reminder calls to the members that they are due a THSteps exam. Mail a reminder “Happy Birthday” card to the member that is due a THSteps exam.

    24. Texas Health Steps A child’s check up must be done no later than 90 days after his or her birthday.

    25. Texas Health Steps A child’s check up must be done no later than 90 days after his or her birthday.

    26. A seasonal farm worker is a person who works on farms, in fields or as a food packer during certain times of the year. Seasonal farm workers move to different places to follow the crops.   

    27. Dear member, let us help you: El Paso First Premier Plan has special Medicaid services for the children of seasonal farm workers and we would like to know the following: Are you a seasonal worker? Yes No Picking onions, chile, lettuce, tomatoes, grapes, pecans, etc…? Yes No Packing or processing vegetables, fruits, fish, chicken, etc…? Yes No In dairies, fisheries, or slaughtering, etc…? Yes No If you answered YES to any of these questions, please contact Lluvia Acuńa, Migrant Coordinator at (915) 532-3778. We will help you receive accelerated services. Thank you for your time!

    28. Lluvia Acuńa Migrant Outreach Coordinator (915) 532-3778 ext. 1075 Laura Caldelas Outreach Supervisor (915) 532-3778 ext. 1108

    29. Member Services Department

    30. Compliance Department

    31. How to Complain?

    32. What is a Complaint?

    33. Claims Department

    34. Claims Guidelines The provider must send electronic claims in a American National Standard Interchange (ANSI) 837P/837I format. The provider must be sending CMS 1500 (Professional) claims. Facility must be send UB04 (Hospital) claims. (Faxed copies will be accepted only if an original is on file for the DOS in inquiry.)

    35. CMS 1500

    36. CMS 1450 UBO4

    37. Claim Verification Clean Claim Edits NPI Verification for Rendering and Referring Provider

    38. Claim Notification Form

    39.      

    40.

    41. H1N1 Reimbursement

    42. Questions?

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