Prior Auth Required

78714 - • Write to Maximus at the STAR program at: PO Box 149219, Austin, TX -9965

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service• Write to Maximus at the STAR program at: PO Box 149219, Austin, TX -9965
Procedure / Service Description

Member Enrollment and Disenrollment From PCHP - either method below: • Call the state enrollment broker, Maximus, at 1-800-964-2777. • Write to Maximus at the STAR program at: PO Box 149219, Austin, TX 78714-9965. The effective date of an enrollment or disenrollment is generally no later than the first day of the second month following the month in which a completed enrollment or disenrollment

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.