You can contact us at 915-532-3778 or toll free at 1-877-532-3778. Provider Relations Department Representatives can be reached during the hours of 8:00 a.m. –5:00 p.m. Mountain, Monday thru Friday.
To join our network, visit our Contracting and Credentialing page.
Contact Provider Relations for:
- Changes in address locations
- Name changes
- Billing company changes
- NPI/TPI updates
- Phone and fax updates, etc.
- Any changes you consider we may need in order to update our system and your records.
- Feb 23.2024.Educational Video and Infographics Now Available to Providers_Telemedicine & Telehealth Delivery
- Feb 15.2024.Updates to Vaccine Administration Procedure Code M0201
- Feb 9.2024.EVV Claims Matching Bypass from Jan 1 to March 31
- Feb 6.2024.Hepatitis C Educational Webinar For Prescribers Occurs March 6 2024
- Feb 6.2024.Reminder HEDIS SEASON
- Jan 25.2024.RSV Monoclonal Antibody Nirsevimab is a Benefit of Texas Medicaid and CHIP
- Jan 25.2024.Provider Type and Places of Service Update for Procedure Code 96372
- Jan 16.2024.Pfizer Oral COVID-19 Drug Paxlovid Added to Formulary.pdf
- Jan 05.2024.UPDATE OB_GYN Prior Authorization No Longer Required for certain Genetic Testing
- Jan 02.2024.Diabetic Equipment and Supplies-Home Health Policy Update Effective Feb. 1 2024
- Dec 20.2023.RSV Vaccine Procedure Code 90678 is Now a Benefit for Pregnant Individuals Effective October 1 2023
- Dec 14.2023.EVV Program Providers and FMSAs Must Download Visit Data by Dec.22
- Dec 14.2023.Change in Preferred Drug List Status for Glucocorticoids Inhaled Drug Class Takes Effect Dec. 15
- Dec 14.2023.Coverage of Vyjuvek Begins Jan. 2024; Prior Authorization Effective Feb. 2024.pdf
- Dec 14.2023.Coverage of Adstiladrin Begins Jan. 2024; Prior Authorization Effective Feb. 2024
- Dec 12.2023.Coverage of Roctavian Begins Jan 2024; Prior Authorization Effective Feb 2024
- Dec 11.2023.Complete EVV Visit Maintenance and Submit VMURs Before Losing Access
- Dec 08.2023.Memo CLIA Guidance
- Nov 30.2023.EVV Cures Act Home Health Care Services (HHCS) Onboard Now.pdf
- Nov 29.2023.HHAeXchange Electronic Visit Verification (EVV) Training Resources
- Nov 28.2023.Change in Preferred Drug List Status for the Macrolides-Ketolides
- Nov 17.2023.Thanksgiving Holiday Office Closure and Check Run Schedule
- Nov 15.2023.Telemedicine and Telehealth Benefit Updates for Rural Health Clinics
- Sept 25.2023.2023-2024 Synagis Season
- Sept 22.2023.EVV Onboard with HHAeXchange
- Sept 22.2023.Qualifications and Ordering an EVV Alternative Device Policy
- Jul 31.2023.Texas Facility Credentialing Application to be Submitted Directly to Verisys
- Jul 28.2023.REMINDER Client Access to Mosquito Repellents Available Through Pharmacy
- Jul 28.2023.EPH-PR-Therapy Re-Evaluation Changes. 07.28.2023.pdf
- Jul 19.2023.EPH-PR-2021 Dashboard-CIS Flu-Flyer.pdf
- Jul 14.2023.COVID-19 Vaccine Administration Procedure Codes Are Now Benefits of Medicaid and CHIP
- Jun 15.2023.OB_GYN Prior Authorization No Longer Required for certain Genetic Testing
- May 30.2023.COVID-19 Vaccine Administration CPT code 0174A is a Benefit of Medicaid and CHIP
- May 30.2023.Alert Inactive NPI in NPPES Cause for Medicaid Disenrollment
- May 30.2023.DME Prior Authorization for Incontinence Supplies
- May 30.2023.EPH-PR-PDL Status Change Smoking Cessation Drug Class Effective 05.30.2023
- May 16.2023.PDL Status Change Smoking Cessation Drug Class Effective 05.16.2023
- May 12.2023.Infection Control Supplies CPT S8301 No Longer a Benefit
- May 01.2023.Maternal Depression Screening
- May 01.2023.EPH-PR – TCM_MHR Removal of DOS Span CORRECTION
- Apr 18.2023.Maternal Depression Screening
- Apr 18.2023.REMINDER A and A BH Secret Shopper Calls
- Apr 11.2023.COVID-19 Vaccine Counseling Procedure Code G0315 Now a Benefit
- Apr 11.2023.PHE Ends May 11 2023_Update Member State Fair Hearing Process
- Mar 28.2023.Multiple COVID-19 Flexibilities for Services Ending.03.28.2023
- Mar 28.2023.PHE Ends May 11 2023_ Update Member State Fair Hearing Process
- Mar 28.2023.PHE Ends May 11 2023_CHIP Co-Pays to Resume May 12 2023
- Mar 28.2023.PHE Ends May 11 2023_Update Provider Re-enrollment Extensions
- Feb 21.2023.Reminder_PCP Provider Performance Improvement Projects(PIPs)
- Feb 16.2023.CLIA Certification Required for Claims
- Feb 1.2023.Updated COVID 19 Waiver of CHIP Co Payments_Extension through April 30 2023
- Feb 1.2023.Updated COVID_19 Telemedicine,Telehealth & Telephone Services (Medical Services)_Extension thru April 30, 2023
- Jan 27.2023.Diabetic Equipment and Supplies Benefits Change for Texas Medicaid
- Jan 27.2023.COVID-19 Vaccine Administration Procedure Codes 0164A and 0173a are Now Medicaid and CHIP Benefits
- Jan 20.2023.Reminder SHP Analytics Provider Survey
- Dec 27.2022.Reminder Happy Birthday Postcards
- Dec 22.2022.Prohibition of Cost Sharing for COVID-19 Vaccine Treatment and Testing Services
- Dec 2.2022.Updated COVID 19 Waiver of CHIP Co Payments_Extension through January 31, 2023
- Dec 2.2022.Updated COVID_19 Telemedicine, Telehealth and Telephone Services (Medical Services)_Extension thru January 31, 2023
- Nov 21.2022.Thanksgiving Holiday Office Closure and Check Run Schedule
- Nov 03.2022.Updated COVID 19 Waiver of CHIP Co Payments_Extension through November 30, 2022
- Nov 03.2022.Updated COVID_19 Telemedicine, Telehealth & Telephone Services (Medical Services)_Extension thru November 30, 2022
- Nov 01.2022.Change to Signature Requirement for Title XIX (Medicaid) Home Health Services
- Oct 27.2022.EPH-PR-Prior Authorization Update Criteria for Adakveo J0791 eff 12/01/2022
- Oct 17.2022.EPHMADSNP_Reminder Update Certify NPI via NPPES
- Oct 03.2022.Updated COVID 19 Waiver of CHIP Co Payments_Extension through October 31, 2022
- Oct 03.2022.Updated COVID_19 Telemedicine, Telehealth & Telephone Services (Medical Services)_Extension thru October 31, 2022
- Sept 29.2022.COVID-19 Procedures Codes 0124A 0134A Benefits for Medicaid CHIP
- Sept 22.2022.MCO COVID-19 Vaccine Admin Procedure Codes Age Changed to 12 Years of Age or Older
- Sept 12.2022.Reminder -Benefit Criteria to Change for Vaccine Services Effective 09012022
- Sept 1.2022.Telemedicine and Telehealth Benefit Information
- Sept 1.2022.Updated COVID_19 Telemedicine, Telehealth & Telephone Services (Medical Services)_Extension thru September 30, 2022
- Sept 1.2022.Updated COVID 19 Waiver of CHIP Co Payments_Extension through September 30, 2022
Quarterly Provider Orientations
- Aug.31.2023.PCP PROVIDER QUARTERLLY ORIENTATION
- Aug.28.2023.PCP PROVIDER QUARTERLLY ORIENTATION INVITE
- Feb.16.2023.PCP PROVIDER QTR ORIENTATION
- May.19.2023.El Paso Health_ OB Specialty Orientation Slides from April
- Feb.16.2023.PCP PROVIDER QTR ORIENTATION
- Oct.21.2022.PROVIDER ANCILLARY TRAINING OCT 27th INVITE
Provider Quality Information
An authorization is required for all inpatient admissions, outpatient procedures, all out- of-area and out-of-network services and other services as defined by El Paso Health, with the exception of family planning services. For a list of procedures requiring authorization please refer to the Pre-Authorization Flyer.
You can find all the necessary forms in our Provider Forms page.
If you have a complaint, you can submit it to the El Paso Health Provider Care Unit at 915-532-3778 or toll free at 1-877-532-3778 You can also send us an email at Complaints_Appeals_Unit@elpasohealth.com or send us a fax at 915-298-7872.
The HHSC mailbox for provider complaints is: HPM_Complaints@hhsc.state.tx.us.
In the event a Provider becomes aware of an overpayment prompt notification shall be reported to El Paso Health. Overpayments shall be returned within 60 days from date of reporting to El Paso Health. In the event overpayment is not received, El Paso Health will proceed to recoup the overpayment from the provider. For reporting please utilize your web portal account quick links Provider Overpayment Reporting tab, email Provider_Overpayments@elpasohealth.com or contact the Provider Care Unit (PCU) at 915-532-3778 x 1504 or toll free 1-877-532-3778.
Provider Advisory Group discussion is held on a quarterly basis via the Utilization Management Committee Meeting. The provider panel provides guidance for enhancements to maintain and continually improve El Paso Health’s service to the provider network, and to ensure provider satisfaction with health plan processes. To participate in the Provider Advisory Group, please call us at 1-877-532-3778.
Proficiency in cultural competency is demonstrated when Providers acknowledge a Member’s point of view of his/her healthcare and integrate that awareness in the delivery of medical services. El Paso Health facilitates Provider orientation sessions to promote our Cultural Competency Plan and educate network Providers about culturally competent services to avoid disparities in the delivery of medical services to the diverse populations of the El Paso SDA.
By contractual agreement, all Network Providers are required to adhere to the standards of the Americans with Disabilities Act (ADA). Our Provider Relations Representatives conduct credentialing site visits as well as quarterly visits to Primary Care Providers, Obstetricians and Behavioral Health Providers, and annual visits to all other specialists, to ensure Providers’ locations are accessible to Members with disabilities. El Paso Health’s Cultural Competency Plan is made available to El Paso Health Network Providers in written form, when requested. Our Provider Manual includes a section on cultural competency.