Provider Forms

PCHP Forms

Appeal and Grievance Process for HEALTHfirst Members

Claim Appeal Request Process and Form

Fax Cover

Newborn Notification Form

Portal User Guide

Prospective Provider Form: Join our Network!

Provider Action Form: Update your information with PCHP

Provider Appeal Request Process & Form

Provider Dispute Request Process & Form

Refund Information Form

Texas Medicaid & Healthcare Partnership

Prior Authorization Forms & Resources