Provider Reference Materials and Forms

woman filing

2017 Provider Forms

TexanPlus® (Houston/Beaumont)

TexanPlus® HMO Authorization Request Form (Houston) pdf icon

TexanPlus® HMO Authorization Request Form (Beaumont) pdf icon

TexanPlus® HMO Authorization Request Form for NWDC pdf icon

TexanPlus® HMO Authorization Request Form for MCA pdf icon

2017 Authorization Guidelines for CIPA pdf icon

2017 Authorization Guidelines for GTPA pdf icon

2017 Authorization Guidelines for Houston Direct pdf icon

2017 Authorization Guidelines for Houston Regional pdf icon

2017 Authorization Guidelines for HPN pdf icon

2017 Authorization Guidelines for KAHPN pdf icon

2017 Authorization Guidelines for MCA pdf icon

2017 Authorization Guidelines for MHAP pdf icon

2017 Authorization Guidelines for MHMG pdf icon

2017 Authorization Guidelines for Millenium pdf icon

2017 Authorization Guidelines for PPMO pdf icon

2017 Authorization Guidelines for PSC pdf icon

2017 Authorization Guidelines for SEP pdf icon

2017 Authorization Guidelines for UTP pdf icon

2017 Authorization Guidelines for VFP pdf icon

TexanPlus® (Dallas/Ft. Worth)

TexanPlus® HMO Authorization Request Form (Dallas/Ft. Worth) pdf icon

2017 Authorization Guidelines for North Texas Market pdf icon

Today's Options® PPO

Today’s Options® PPO Authorization Request Form pdf icon

2017 Today's Options® PPO Authorization Guidelines pdf icon

2018 Provider Forms

TexanPlus® (Houston/Beaumont)

Authorization Request Form for GPTA pdf icon

Authorization Request Form for Houston pdf icon

Authorization Request Form for NWDC pdf icon

Authorization Request Form for MCA pdf icon

Authorization Guidelines for CIPA pdf icon

Authorization Guidelines for GTPA pdf icon

Authorization Guidelines for Houston Direct pdf icon

Authorization Guidelines for Houston Regional pdf icon

Authorization Guidelines for HPN pdf icon

Authorization Guidelines for KAHPN pdf icon

Authorization Guidelines for MCA pdf icon

Authorization Guidelines for MHAP pdf icon

Authorization Guidelines for MHMG pdf icon

Authorization Guidelines for Millenium pdf icon

Authorization Guidelines for PPMO pdf icon

Authorization Guidelines for PSC pdf icon

Authorization Guidelines for UTP pdf icon

Authorization Guidelines for VFP pdf icon

TexanPlus® (Dallas/Ft. Worth)

Authorization Request Form pdf icon

Authorization Guidelines for North Texas Market pdf icon

Today's Options® PPO

Authorization Request Form pdf icon

Today's Options® PPO Authorization Guidelines pdf icon

Today's Options® HMO

Authorization Request Form pdf icon

Today's Options® HMO Authorization Guidelines pdf icon

2017 Provider Directories

2017 Provider Directory TexanPlus HMO Beaumontpdf icon

2017 Provider Directory TexanPlus HMO-POS Beaumontpdf icon

2017 Provider Directory TexanPlus HMO Dallas/Ft Worth pdf icon

2017 Provider Directory TexanPlus HMO Houston pdf icon

2017 Provider Directory TexanPlus HMO-POS Houston pdf icon

2017 Provider Directory TexanPlus HMO City of Houston pdf icon

2017 Provider Directory TexanPlus Star HMO-SNP Houston/Beaumont pdf icon

2017 Provider Directory Today’s Options PPO Maine pdf icon

2017 Provider Directory Today’s Options PFFS Maine pdf icon

2017 Provider Directory Today’s Options PPO New York East pdf icon

2017 Provider Directory Today’s Options PFFS New York East pdf icon

2017 Provider Directory Today’s Options PPO New York West pdf icon

2017 Provider Directory Today’s Options PFFS New York West pdf icon

2018 Provider Directories

2018 Provider Directory TexanPlus HMO Beaumontpdf icon

2018 Provider Directory TexanPlus HMO-POS Beaumontpdf icon

2018 Provider Directory TexanPlus HMO Dallas/Ft Worth pdf icon

2018 Provider Directory TexanPlus HMO Houston pdf icon

2018 Provider Directory TexanPlus HMO-POS Houston pdf icon

2018 Provider Directory TexanPlus HMO City of Houston pdf icon

2018 Provider Directory TexanPlus Star HMO-SNP Houston/Beaumont pdf icon

2018 Provider Directory Today’s Options PPO Maine pdf icon

2018 Provider Directory Today’s Options PFFS Maine pdf icon

2018 Provider Directory Today’s Options PPO New York East pdf icon

2018 Provider Directory Today’s Options PFFS New York East pdf icon

2018 Provider Directory Today’s Options PPO New York West pdf icon

2018 Provider Directory Today’s Options PFFS New York West pdf icon

2018 Provider Directory Today’s Options HMO pdf icon

  • text size :  
  • A
  • A
  • A