Provider Forms and Resources
Below you can find our most frequently used provider forms and resources for CHRISTUS Health Plan and US Family Health Plan.
Phone Numbers
- Health Insurance Exchange: 1-877-650-4643
- Medicare Advantage: 1-888-437-1981
- US Family Health Plan: 1-833-947-0714
If you are in need of assistance due to impaired hearing, please call 711.
Hours
- Health Insurance Exchange: 8 a.m. to 5 p.m., local time, Mon. – Fri.
- Medicare Advantage: 8 a.m. to 8 p.m., local time, 7 days a week, Oct. 1 – Mar. 31; and 8 a.m. to 8 p.m., local time, Mon. – Fri.
- USFHP: 8 a.m. to 5 p.m., Mon. – Fri.
Forms
- Quality Referral for Case Review for Potential Quality Issue (PQI)
- Member Acknowledgement Form (PDF)
- Private Pay Agreement Form (PDF)
- Consent for Disclosure of Confidential Information Form (PDF)
- Training Attestation Form – Gen. Compliance and FWA Form (PDF)
Medicare Advantage Resources
- Provider Letter - Change to Medicare ID Card (PDF)
- QMB Provider Notification Letter (PDF)
- Notice to Physicians and Providers (PDF)