Texas Providers

Need to submit a claim? Check on a payment? Find a form? Follow the links below.

Questions? Call us at 1-877-762-3515.

Guidance for the COVID-19 Public Health Emergency

We're adhering to federal guidance during the current public health emergency. Learn about what that means for you and our members.

Working with Devoted

Want to join our provider network? Just complete this form.

View our Provider Quick Reference Guides to get key contacts and other essential info:

• 2020 Houston Provider Quick Reference Guide (Last updated 11/15/2019)
• 2021 Houston Provider Quick Reference Guide (Last updated 8/10/2020)
• 2021 San Antonio Provider Quick Reference Guide (Last updated 1/08/2021)

View our Texas Provider Manual to go in-depth on how we’ll work together:

• 2020 Texas Provider Manual (Last updated 6/4/2020)
• 2021 Texas Provider Manual (Last updated 8/27/2020)
• What can you say about our plans to patients? We’ve made a handy cheat sheet that can help with that.
• View our Clinical Guidelines for best practices for managing chronic diseases
• Check our HEDIS Tip Sheet for ideas on how to improve key HEDIS measures
• View our In-Office Lab List to find out which lab tests you can do in your office

Provider Directory and Formulary

• Search for in-network providers, pharmacies, and facilities
• Search our formulary, see the latest formulary changes, or learn about drug coverage limits

Provider Trainings

• View our Provider Lunch and Learn Webinars

Submitting a Claim

You have 3 options: Change Healthcare, Availity, or paper claims.

Change Healthcare
You'll need to work with your practice management system to connect to Change Healthcare.

Availity
You can use Availity to submit claims, referrals, and more. See the next section for detailed instructions.

Paper Claims
We suggest submitting your claims electronically through Change Healthcare or Availity. If you'd rather use paper claims, here's the data you'll need:

• Professional CMS 1500
• Institutional CMS 1450 (“UB-04”)

Make sure to send your paper claims to:
Devoted Health, Inc.
Claims
PO Box 211524
Eagan, MN 55121

Any claims sent to our older Waltham, MA address may be returned as undeliverable.

Using Availity

• Log in to Availity to submit claims, check member eligibility, enroll for Electronic Remittance Advice (ERA), and request referrals and prior authorizations
• Learn how to determine patient eligibility
• Learn how to submit prior authorizations and referrals
• Learn how to view Stars performance and download reports

Payspan

• Log in to Payspan to register for EFT
• Find out how to register for Payspan

Plan Details

• Learn about 2021 benefit changes
• View 2021 plan documents

OTC Catalog

• 2020 OTC Catalog (English and Spanish)
• 2021 OTC Catalog: English | Spanish

Referrals

• 2020 referral list
• 2021 referral list

Prior Authorizations

• 2020 prior authorization list
• 2021 prior authorization list
• How to get faster PA responses
• Prior authorization request form

Part D Forms

Submit Online

• Coverage determination request form
• Redetermination request form

Download for Printing

• Coverage determination request form
• Redetermination request form
• Reconsideration request form

Disease and Case Management

Does one of our members need disease or case management? Use our disease and case management referral form to let us know.

Roster Updates

Use these templates to update your rosters. Please email your updates to provider-updates@devoted.com.

• Provider roster template
• Facility roster template

HIPAA Policies

Review our HIPAA compliance policies

Other Forms and Documents

• Waiver of Liability Statement
• Medicare Advantage Regulatory Attachment