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Texas Parity Resources

Depending on whether you are filing a complaint or appeal, the contact information below should be able to help you if you have any questions.

For general information about filing a parity appeal for mental health or addictions services, you cannot go wrong with contacting one of the consumer advocates below. Each has years of experience helping consumers in the state of Texas.

Texas Health and Human Services Commission
Resolution Services-H-6100
1100 W 49th Street
Austin, TX 78756-3168
Notifying the Consumer of the Appeals Process

When filing an appeal for the first time, you should contact your health plan’s customer service support line or check out their information online. If you choose to appeal an adverse benefit determination concerning your mental health or substance use treatment or benefits, please keep in mind that the timeframe to do so varies by state, plan type, and other factors. Contact your state’s department of insurance for additional information. Here is some contact information for Texas Health Plans:

BlueCross BlueShield of Texas
File a complaint by phone: 888-292-4480
Submit a complaint by mail:
Blue Cross and Blue Shield of Texas
PO Box 684249
Austin, TX 78768
To file an appeal send to:
Attn: Complaints and Appeals Unit
Blue Cross and Blue Shield of Texas
PO Box 684249
Austin, TX 78768

CHRISTUS Health
Appeals and Grievance Information
Send to:
CHRISTUS Health Plan
Attn: Appeal and Grievance Dept.
PO Box 169009
Irving, TX 75016
Fax: (866) 416-2840

Community First
Call Member Services department: 210-358-6262 or 800-434-2347
Complaint form found here
Complaint forms submit to:
Attn: Member Services Resolution Unit
12238 Silicon Drive, Suite 100
San Antonio, TX 78249

FirstCare
Call Customer Service: 800-431-7798 or 877-639-2447

IdealCare/Sendero Health Plans
Call Customer Service: 888-643-3251
Appeals submit to:
Sendero Health Plans
ATTN: Sendero Reconsiderations
PO Box 3869
Corpus Christi, TX 78463

Molina Health Care
Call Member Services: 866-449-6849 ext 752054
In writing send to:
Molina Healthcare of Texas
Attn: Member Complaints & Appeals
PO Box 165089
Irving, TX 75016

Oscar Health
For assistance call 855-672-2755 Grievance/Complaint Form

Scott & White Health Plan
Call Customer Service: 800-321-7947 United Healthcare Call the Customer Service number on the member ID card.

Insurance Commissioner
Texas Department of Insurance
Commissioner
P.O. Box 149104
Austin, TX 78714-9104
Toll Free: (800) 578-4677
Phone: (512) 676-6000
Fax: (512) 490-1045

Utilization Management Appeals
Texas Department of Insurance, MCQA Office
Director
333 Guadalupe Street
Austin, TX 78701
Phone: (512) 322-4266
Fax: (512) 490-1013

External Review Appeals
Texas Department of Insurance
333 Guadalupe Street
Austin, TX 78701
Phone: (512) 676-6401

Parity Appeals
Texas Department of Insurance, MCQA Office
Director
333 Guadalupe Street
Austin, TX 78701
Phone: (512) 322-4266
Fax: (512) 490-1013

Additional Texas Insurance Administration Contacts, click here

The federal government also can be a helpful resource if you are enrolled in a self-funded plan, Medicare, Medicaid or another type of insurance that is overseen at least in part by a federal agency.

For definitions and filing information refer to the Parity Resource Guide

U.S. Department of Health and Human Service’s website on the Affordable Care Act health reform law

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA)

(SAMHSA) Implementation Mental Health Parity Addiction Equity Act

U.S. Centers for Medicare and Medicaid Services (CMS)

U.S. Department of Labor, Employee Benefits, Security Administration (EBSA) or toll-free hotline: 1.866.444.EBSA (3272)

For the U.S. Department of Health and Human Services & Centers for Medicare and Medicaid Services list of exempt state and local plans, please email NonFed@cms.hhs.gov. You may ask them if any particular state and local plan has opted out of MHPAEA.

Information on requirements of employer-based insurance coverage and self-insured health plans.
EBSA has benefit advisors who are available to answer questions and provide assistance in obtaining your benefits.

Consumer Guide to Disclosure Rights: Making the Most of Your Mental Health and Substance Use Disorder Benefits

Veterans and military personnel can use these resources to get help or more information with their medical or behavioral health complaints.

Health Net Federal Services

A grievance is a written complaint or concern about a medical provider.
Click here for specific information regarding who, what and how to file.

TRICARE

View the recently released Tricare Mental Health Fact Sheet.

The appeal process is different based on the benefit issue. Depending on your issue, you can file a:

  • Factual appeal
    • This is if you were denied payment for services or supplies you received, or if payment was stopped for services or supplies previously authorized.
  • Medical necessity appeal
    • This is if prior authorization for care or services was denied because it was not deemed medically necessary. Medically necessary means it must be appropriate, reasonable, and adequate for your condition.
  • Pharmacy appeal
    • This is if you don’t agree with a decision made about your pharmacy benefit. For example, Express Scripts denies your pharmacy claim.
  • Medicare-TRICARE appeal
    • This is if you’re eligible for both TRICARE and Medicare, and Medicare denies your services or supplies.

If your care is denied, you should receive a letter with details about how to file your appeal.

Veterans Health Administration

Complaints are initially handled through the Patient Advocate.
Patient Advocate can be contacted at your local VA Medical Center.

If you have any additional questions about parity compliance, please contact info@paritytrack.org

More Parity Information:

Please note: Parity Registry does not automate the appeals process. The information you provide may alert policymakers to possible health plan violations of the law, thereby helping to shape public policy and influence legislation.

You must take follow-up action with your health plan or regulatory agency.