All your forms and tools in one place

Provider Manual

View or download the RightCare Provider Manual.

Provider Forms and Resources

Provider Services Forms

• New Facility Contract Form
• New Individual & Group Contract Form
• Add Provider to Existing Contract
• Add Facility to Existing Contract
• Provider Information Change Form

Payment Forms

• Electronic Funds Transfer (EFT) Authorization Agreement
• Private Pay Agreement

Sterilization Forms

• Sterilization Consent Form Instructions
• Sterilization Consent Form
• Sterilization Consent Form (Spanish)

Service Coordination Forms

• Service Coordination Request Form
• Mental Health Targeted Service Coordination and Mental Health Rehabilitative Services Request Form
• Pregnancy Notification Form
• Instructions for completing the Pregnancy Notification Form

Texas Health Steps

• See Texas Health Steps section below

LARC Information and Resources

LARC Training: Please visit the web-based "quick course" for providers about Long-Acting Reversible Contraception (LARC). This short course explains why and how to integrate LARC into routine clinical practice. See the course here.

• Healthy Texas Women Family Planning, Birth Control
• Texas LARC Toolkit
• Texas Medicaid Provider Procedures Manual LARC Policy
• Texas Vendor Drug Program LARC Products

In addition, ACOG has compiled a variety of LARC clinical and training resources. LARCs are a covered service in both the Healthy Texas Women program and the Family Planning Program. For further information about these and other women’s health services, see the Healthy Texas Women website.

Provider Resources

• Provider Portal Reference Guide
• Authorization to Release Protected Health Information (PHI)
• Authorization to Release Protected Health Information (PHI) (Spanish)
• Update Enrollment and Demographic Information
• BH Referral Authorization Form & Instructions
• Provider Claim Appeal Reconsideration Form
• Refund Information Form
• TMHP Supplemental Forms
• RightCare Authorization Request Form & Instructions
• Corrected Claim and Redetermination Information

Provider Reference Guide

Refer to the Provider Reference Guide for information on claims, eligibility, and other RightCare services.

Clinical Practice Guidelines

• CDC Guideline for Prescribing Opioids for Chronic Pain
• ADHD Clinical Guideline
• Depression Screening and Follow-Up Guideline
• Asthma Guideline
• COPD Assessment Management and Use of Spirometry Guideline
• Hypertension Management Guideline

Texas Health Steps (THSteps)

• RightCare Texas Health Steps Provider Training
• Texas Health Steps Online Training
• Texas Health Steps Medical Checkup Periodicity Schedule
• Provider Letter re: Texas Health Steps Documentation Improvement
• THSteps Clinical Records Review Tool with Instructions
• Texas Health Steps Clinical Record Review Tool
• Texas Health Steps Regional Provider Representatives