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Provider Materials

Claim Forms

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Corrected Claim
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Clean Claim Elements
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CMS 1500 02-12
Claim Form Manual
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New CMS 1500 Guidance
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Nursing Facility Claim Issue Log
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References

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Provider Manual CHIP, STAR & STAR+PLUS
Updated Sept. 2024
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STAR+PLUS Nursing Facility Provider Manual
Updated Sept. 2025
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Member Handbooks
and Provider Directories
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STAR/CHIP/STAR+PLUS
Quick Reference Guide
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CMS Cell & GeneTherapy – Provider Billing Instructions
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Upcoming Provider Training Orientations

Join us for an engaging training session focused on El Paso Health policies and processes, tailored to expand your understanding of critical topics. These sessions provide valuable insights into key resources that benefit both members and providers.

Class sizes are limited. Details regarding upcoming Provider Training Orientations are subject to change.
Thursday, Oct. 2, 2025
PCP Provider Quarterly Training
12:00-1:30 pm

IN-PERSON, Multipurpose Room
  • STAR+PLUS Webpage
  • Member ID Cards
  • Accessibility and Availability
  • Transportation/NEMT
  • Fraud, Waste, and Abuse
  • Claims
View PDF Invite >> Sign-up Here
Thursday, October 30, 2025
STAR,CHIP & STAR+PLUS OB/GYN
12:00-1:30 pm

IN-PERSON, Multipurpose Room
Sign-up Here
Tuesday, November 18, 2025
Medicare Advantage
2:00-3:30 pm

IN-PERSON, Multipurpose Room
Sign-up Here
Thursday, January 29, 2026
Medicare Advantage & DSNP
12:00-1:30 pm

IN-PERSON, Rio Grande Room
Sign-up Here
Thursday, February 26, 2026
STAR+PLUS LTSS
12:00-1:30 pm

IN-PERSON, Multipurpose Room
Sign-up Here
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For New or Renewed Members
Food from the Heart

Receive a $25 gift card for attending an EPH New Member Orientation.
Learn More
For Pregnant Members
Baby Shower

A Baby Shower including a diaper bag, a starter supply of diapers, and other items for the baby.  A free convertible car seat after attending a baby shower at El Paso Health.
Learn More
For New or Renewed Members
Stay Safe Kit

Receive a Stay Safe Kit for attending a an EPH wellness class.
Learn More
For New or Renewed Members
Food from the Heart

Receive a $25 gift card for attending an EPH New Member Orientation.
Learn More
For Pregnant Members
Baby Shower

A Baby Shower including a diaper bag, a starter supply of diapers, and other items for the baby.  A free convertible car seat after attending a baby shower at El Paso Health.
Learn More
For New or Renewed Members
Stay Safe Kit

Receive a Stay Safe Kit for attending a an EPH wellness class.
Learn More
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Please email ProviderRelationDG@elpasohealth.com or contact the Provider Services Department at 915-532-3778 for question or suggestions with topics for future events.

Provider Training Presentations

July 7, 2025
HomeHealth /DME Provider  Training
View Presentation >>
April 24, 2025
Behavioral Health Provider Training
View Presentation >>
March 27, 2025
PCP/OB/ Family/Internist /Geriatrics Training Presentation
    View Presentation >>
    Archived Quarterly Provider Orientations
    Click below to view presentations from previous provider orientations.
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    View Presentations

    Provider Updates

    Visit our Provider Update Archive page to see the full list.
    September 17, 2025
    Prior Authorizations Extended Due to 2025 Flooding
    Read More
    September 17, 2025
    Provider Revalidation Flyer
    Read More
    September 17, 2025
    Reminder: CLIA Updates for Some Procedure Codes
    Read More
    September 17, 2025
    Provider Guidance: Nutritional Supplements for DME Providers
    Read More
    September 17, 2025
    OB/GYN Prior Authorization No Longer Required for certain Genetic Testing
    Read More
    September 17, 2025
    BEHAVIORAL HEALTH: Improving Discharge Planning Coordination
    Read More
    June 10, 2025
    Home Health DME Provider Orientation Flyer
    Read More
    June  9, 2025
    Rental of Dual-Function Home Ventalators a Benefit of Texas Medicaid Eff. April 1, 2025
    Read More
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    Complaints and Appeals Forms
    Request for a Review by an Independent Review Organization – English Request for a Review by an Independent Review Organization – Spanish
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    Credentialing Packet Forms
    Fiscal Year 2025 Enhancement for Attendant Compensation- Request for Participation DME Supplies Form Home Health Form Demographic Form W9 Form – Request for Taxpayer Identification Number and Certification Credentialing Checklist for Organization/Facility Credentialing Application for Organization Secondary Locations for Organization Credentialing & Re-Credentialing Checklist for Physician Texas Standardized Credentialing Application EFT Form
    Visit the Provider Contracting and Credentialing page for more information. If you have any questions, please contact us at 915-532-3778 or toll free at 1-877-532-3778.
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    Health Services Forms
    ABA Request Checklist Therapy Request Checklist CCP Prior Authorization Request Form STAR/CHIP Pre-Authorization Flyer EFF 10.1.2023 Texas Standard Prior Authorization Form for Health Care Services Prior Authorization Form – Out of Area Inpatient Prior Authorization Form – NICU Provider Guide to In-Lieu of Services IUD Abandoned Unit Return Form Case Management Referral Form Behavioral Health Prior Authorization Form
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    Member Services Forms
    Authorization to Disclose information to PCP 1027 Medicaid Eligibility Form Specialist as a PCP Request Form Primary Care Provider Change Request Form
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    Misc. Forms
    El Paso Health Payer Identifications Electronic Remittance Advice (835) Request Form HealthX Fax System
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    Provider Resources
    Click here to visit the Texas Medicaid and Healthcare Partnership website.

    Click here to visit the Texas Health and Human Services Commission website.
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    Provider Portal Training Guidance Medicare Advantage HMO-D-SNP Provider Quarterly Training Session El Paso Health Provider Survey Flyer EVV Home Health Care Services (HHCS) Service Bill Codes Table Now Available Medicaid Applied Behavior Analysis (ABA) Services for Children and Youth With Autism Contract Checklist Version 2.7 Ch 8_1 EFF June.1.2023 Formularies Available on Epocrates Texas HHS Vendor Drug Program Home Page Formulary Drug Search Navitus Pharmacy Quick Reference Guide 2019 Preferred Drug List TCHAP Resources The Texas Clinician’s Postpartum Depression Toolkit TMHP for NPI Attestation TMHP Provider Procedures Manual El Paso Health_CHIP_EOC_Schedule_A_Final_010719 El Paso Health_CHIP_EOC_Schedule_B_Final_010719 El Paso Health_CHIP_EOC_Schedule_C_Final_010719 El Paso Health_CHIP_EOC_Schedule_D_Final_010719 CHIP Perinatal Program for Unborn Children-Evidence of Coverage CHIP Perinatal Program for Perinatal Newborns-Evidence of Coverage Waste, Abuse and Fraud Educational Link
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    Medicaid Autism Services Family Flyers
    Medicaid Applied Behavior Analysis (ABA) Services for Children and Youth With Autism
    For more information, please visit our Autism Spectrum Disorder page.
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    1145 Westmoreland Drive
    El Paso, TX 79925-5615

    Call us at 915-532-3778 STAR/CHIP
    Outside El Paso 1-877-532-3778 STAR/CHIP

    Call us at 1-833-742-3127 STAR+PLUS

    Hours of Operation
    8:00 A.M. – 5:00 P.M. MST
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    The information posted on this website may be available in other formats such as large print, Braille, and audio. You can request the materials in other formats by calling Member Services at 1-877-532-3778.
    General Info
    Home Do I Qualify? Members Providers About Us Contact Us Volunteer Site Map
    Career Opportunities
    For current job openings at El Paso Health click here.
    Important Info
    Important Phone Numbers Statement of Non-Discrimination Members Rights and Responsibilities
    Paper Claim Submissions
    El Paso Health - Claims
    P.O. Box 971370
    El Paso, TX 79997-1370

    General Correspondence
    P.O. Box 971100
    El Paso, TX 79997-1100
    You can also report fraud, waste and abuse directly to the Texas Office of Inspector General.
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