Availability of Materials in Alternate Formats
If you need any RightCare materials in a different format such as audio, large print, braille, or in a language other than English and Spanish; contact RightCare Member Services.
Office of Inspector General (OIG) Website Link:
Report Waste, Abuse, or Fraud to the Inspector General
Member Support
Member Services
If you have questions, call us at 1-855-TX-RIGHT. Our staff is bilingual in English and Spanish. If you speak another language or are hearing impaired, call Member Services at 1-855-TX-RIGHT (TTY 711) for help.
Regular Business Hours: Monday to Friday, 7 a.m. to 7 p.m. Central Time (except for state-approved holidays). If a medical condition is life-threatening, members should go to the emergency room. If the medical condition is non-life-threatening you can seek care at an urgent care facility or get urgent medical care from your primary care provider (PCP) within 24 hours.
If you call after hours, please leave us a message. We return all calls the next business day.
You can also visit the 24/7 Member Portal or send a Secured Message in Member Portal.
Provider Services Hotline
If you have questions, call us at 1-855-TX-RIGHT. Regular Business Hours: Monday to Friday, 8 a.m. to 5 p.m. Central Time (except for state-approved holidays). Provider can call to verify eligibility and claim inquiries.
Behavioral Health Hotline Number
If you need mental health or substance abuse services, you can call a Behavioral Health Service Coordinator at 1-855-395-9652. Behavioral Health Services are private so you do not need permission from your PCP to get these services. If you are in crisis, you can call the behavioral health crisis line anytime 24 hours a day, 7 days a week, you will not get a recording. Our staff is bilingual in English and Spanish. If you need, we can arrange for an interpreter to help you. If a medical condition is life-threatening, members should go to the emergency room. If the medical condition is non-life-threatening you can seek care at an urgent care facility or get urgent medical care from your primary care provider (PCP) within 24 hours.
Need a Ride? Nonemergency Medical Transportation (NEMT)
- Starting June 1,2021, we can help you or your child get a ride, at no cost, to the doctor, hospital, dentist, and drugstore.
- Call us 48 hours before at 1-877-447-3101 (TTY 711) or download the Access2Care (A2C) app.
- All you need is your ID number, provider’s name, and the address.
- Click here to learn more.
- Postcard Sample
STAR Program Help Line (Enrollment Broker)
1-800-964-2777 (TTY: 711). Regular Business Hours: Monday to Friday, 8 a.m. to 6 p.m. CT (except state-approved holidays). The Texas STAR Program Help Line can help members change their address or phone number, or sign up their baby after birth.
Fair Hearing
If you, as a member of the health plan, disagree with the health plan’s decision, you have the right to ask for a fair hearing only after exhausting the MCO Internal Appeal System provided by RightCare. Members may ask for a State Fair Hearing by contacting us toll-free at 855-897-4448 (1-855-TX-RIGHT). RightCare’s Member Services can help you file a fair hearing.
External Medical Review
If you, disagree with the health plan’s decision, you have the right to ask for a State Fair Hearing (standard or expedited) only after exhausting the RightCare Internal Appeals process or you can ask for a State Fair Hearing with an External Medical Review (EMR) (standard or expedited). You cannot only ask for an External Medical Review. An EMR is an optional, extra step for the member to have a case outside the Hearing, free of charge. To request an EMR, call us at 1-855-897-4448.
Updated Information on EMR added to Appeals and Complaints Process page (linked off Member Homepage)
Appeals Process (linked off Member Homepage)
Subcontractor Information
RightCare uses the following subcontractors to provide members and providers the best experience:
Office of Consumer Credit Commissioner
Click here.