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. CT, Monday to Friday (except state-approved holidays) TTY: 711.
Medical
Service Coordination 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, RightCareMembers 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
United Dental: 1-877-901-7321
Phone Numbers for Providers
SWHP Provider Relations Representative Territory Map
Provider Relations (including claims questions)
1-855-TX-RIGHT(897-4448) 8 a.m. to 5 p.m. CT, Monday to Friday (except 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
1-866-566-8989TTY: 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 tips.oig.hhs.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