Provider Forms | UnitedHealthcare Community Plan of Texas
See the items below to stay up-to-date with forms that are important to your practice.
Completing Title XIX DME/Medical Supplies Form For Texas Medicaid Plans
Provider Forms
- Attendant Compensation Enhancement Program (ACEP) Form - Please submit your form between August 1, 2024 and by 5 p.m. CT on October 1, 2024.
- Care Provider Complaint Form
- Critical Incident Reporting Form
- HHSC’s Parent and Child Anticipatory Guidance and Health Education for Texas Health Steps Checkups
- Medicaid Pre-Service Appeal or Grievance
- Notification of pregnancy
- Obstetrical risk assessment form
- Prior Authorization Forms
- Synagis Enrollment Form
- Texas REACH nomination form
Submit a Pre-Service Appeal and or Grievance for a Medicaid Member