Here’s a handy list of numbers for all RightCare member services. You can also find this list in your member handbook.

Phone Numbers for Members

Member Services

Our Member Services staff is here to help you. We have staff available who speak English or Spanish. If you need, we can arrange for an interpreter to help you. 1-855-TX-RIGHT (1-855-897-4448) 7 a.m. to 7 p.m. Central Time, Monday to Friday (except for state-approved holidays) TTY: 711

Medical

Case Management 1-855-897-4448

Behavioral Health Case Management 1-855-395-9652

24-Hour Nurse Line

Need care advice? Have a medical question? Not sure if you should see a doctor? For non-emergency symptoms and health or treatment questions, RightCare Members have access to talk with a nurse 24 hours a day, every day. Get the information you need any time of the day or night by calling 1-855-828-1013. Information is available in English and Spanish. Interpreter services available upon request. TTY users can call 7-1-1.

Compliance Hotline

Report Fraud, Waste & Abuse

1-888-484-6977

Behavioral Health Crisis Hotline (24/7)

1-844-436-8781

Vision Benefits Information

Superior/Block Vision:

1-800-879-6901

Dental Benefits Information

DentaQuest: 1-800-516-0165 MCNA Dental: 1-800-494-6262 Liberty Dental (value-added service for pregnant women): 1-877-550-4374

Phone Numbers for Providers

SWHP Provider Relations Representative Territory Map

Provider Relations (including claims questions)

1-855-TX-RIGHT (1-855-897-4448) 8 a.m. to 5 p.m. Central Time, Monday to Friday (except for state-approved holidays)

Prior Authorizations and Notifications

RightCare: 1-855-691-7947 Pharmacy: 1-877-908-6023 Behavioral Health: 1-855-395-9652

Eligibility Verification (IVR Line)

1-800-925-9126

Compliance Hotline

1-888-484-6977

Additional Helpful Phone Numbers

Ombudsman Managed Care Assistance Team

1-866-566-8989 TTY: 711

MAXIMUS – Enrollment Broker

1-800-964-2777

Eligibility Verification (IVR) Line

1-855-897-4448

Early Childhood Intervention (ECI)

A state program for families with children, birth to age 3, who have disabilities or are delayed. It supports families to help their children reach their potential. ECI Care Line: 1-800-628-5115

DARS (Department of Assistive and Rehabilitative Services) Inquiries Line:

1-800-252-5204

Office of the Inspector General Hotline (OIG)

1-800-436-6184 Fraud, waste, and abuse harms us all. If you think a doctor, other provider, or a person who gets benefits is misusing state benefits. Call the HHSC Inspector General Integrity Line at 1-800-436-6184 or report it online at oig.hhsc.texas.gov

Department of Family and Protective Services

1-800-252-5400

Nonemergency Medical Transportation (NEMT)

Call us 48 hours before at 1-877-447-3101 (TTY 711) or download the Access2Care (A2C) app.

WIC (Women, Infants and Children Nutrition Program)

1-800-942-3678