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Medical Appeals & Provider
Resolution Division
Send written Fee-For-Service or Primary Care Case Management appeals and complaints to:
Texas Health and Human Services Commission
HHSC Claims Administrator Contract Management
PO Box 204077, Mail Code 91-X
Austin, Texas 78720-4077
Medicaid
managed care providers must exhaust the complaints or grievance
process with their managed care health plan before filing a
complaint with HHSC. If after completing this process, the
provider believes they did not receive full due process from the
respective managed care health plan, they may file a complaint
or inquiry at HPM_complaints@hhsc.state.tx.us
or:
Texas Health and Human Services Commission
Provider Complaints
Health Plan Operations, H-320
PO Box 85200
Austin, Texas 78708
For additional information visit the Texas Administrative Code,
1 TAC 354.1003, Subchapter I.
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