Providers have the right to appeal claims disputes, prior authorization decisions and file a complaint with a Managed Care Organization and the State. Information on how to file an appeal and complaint is located on each MCO website. Providers may contract the MCOs using the below listed information.
800-306-8612 (Tarrant service area)
800-248-7767 (Bexar service area)
Amerigroup
800-454-3730
Provider Appeals:
P.O. Box 61599
Virginia Beach, VA 23466-1599
Provider Complaints:
P.O. Box 61789
Virginia Beach, VA 23466-1789
Blue Cross and Blue Shield of Texas
800-947-4969
214-867-5526
877-428-3057 (Medicaid)
800-359-5613 (CHIP)
469-282-3012 (Fax)
800-434-2347
888-760-2600 (STAR/CHIP)
855-315-5386 (Marketplace)
800-964-2247
CHIP, STAR & STAR Kids
Cook Children’s Health Plan
P.O. Box 2488
Fort Worth, TX 76113
877-451-5601(STAR/CHIP) | 844.883.2422
Seton Health Plan (STAR/CHIP)
Member Services
P.O. Box 14545
Austin, TX 78761
Seton Insurance Company
Attention: Administrative Appeals
PO Box 1700
Piscataway, NJ 08855-1700
Utilization Management appeals:
Seton Appeals
PO Box 760
Piscataway, NJ 08855-0760
877-324-3627 (Nueces service area)
855-425-3247 (Hidalgo service area)
877-532-3778
800-431-7798 (STAR)
877-639-2447 (CHIP)
800-884-4905 (Providers)
855-322-4080
877-319-6852
214-934-4564
844-800-4693
855-297-9191 (Appeals)
855-297-9191 (Appeals)
800-731-8527 | email
888-887-9003
UnitedHealthcare Community Plan
Attn: Complaint and Appeals Dept.
PO Box 31364
Salt Lake City, UT 84131-0364
STAR and STAR+PLUS providers have the right to submit complaints to the Texas Health and Human Services Commission (HHSC) Provider Resolution Services by calling the Ombudsman at 877-787-8999.
CHIP providers have the right to submit complaints to the Texas Department of Insurance (TDI).