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CHP+ Managed Care Network Provider Directory

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Claims Submission & Billing
TPA - Third Party Administrator
Colorado Access, a Non-Profit health plan that provides access to health services for medically underserved Coloradans, acts as the third-party administrator for the CHP+ Managed Care Network. Colorado Access provides the following services:
  • Issues ID Cards
  • Processes Claims
  • Provider Network Management
  • Pre-authorization services
  • Quality Program Administration
CHP+ Managed Care Network providers are contracted directly with the State of Colorado, Department of Health Care Policy and Financing (HCPF), not with Colorado Access.

Anthem Claims Run-out

Newborn Hospitalization Billing


You can access www.coaccess.com for more information on Colorado Access.

Claims
The CHP+ Managed Care Network provider contract prohibits a contracted provider from balance billing CHP+ members.

CHP+ requires every practice to submit claims for all services delivered to CHP+ members. Only those claims that qualify for fee-for-service reimbursement will be paid.

To facilitate claims processing, CHP+ contracted providers must abide by Colorado Access' claims filing procedures. All services rendered by specialty providers will be considered claims. Claims for professional services can be billed on a CMS1500. Claims for facility services can be billed on a UB04. All services are reimbursed using the current CHP+ Fee Schedule.

Send claims to:
CHP+ Claims
State Managed Care Network
PO Box 17470
Denver, CO 80217-0470


CHP+ strongly encourages the submission of electronic claims. Electronic claims submission is fast, accurate, and reliable. Electronic claims can be submitted 24 hours a day, seven days a week, and will be processed faster than paper claims. Please contact State Managed Care Network for more information on electronic claims submission at 303-751-9051 or 1-800-414-6198.

The following information is needed when submitting claims information:

  • Patient's name
  • Patient's CHP+ member number
  • Date of Birth
  • Gender
  • Date of Service
  • Place of Service
  • Procedure codes (CPT-IV*)
  • Diagnosis codes (ICD-9)
  • Billed charges
  • Copayment (if not collected at the time of the visit, please record the amount that should have been collected)
  • The insurer's name (CHP+)
  • Provider's tax ID
  • Provider's billing address
*Providers must bill with current CPT-IV codes. Procedure descriptions that have been deleted from the currently recognized CPT-IV codes cannot be read by the Colorado Access claims processing system.

If applicable:
  • Accident information
  • Number of units of service
  • Authorization number

Timely Filing
CHP+ participating providers are subject to a 180-day timely filing clause. CHP+ is not liable for any reimbursable charges if the charges are not submitted within the 180 consecutive days immediately following the date(s) of service or if a good faith effort to submit such charges is not made. CHP+ members are not liable for charges not submitted within the 180-day timely filing period.

Claims Status
CHP+ contracted providers can check their claim status by using the Colorado Access website at www.coaccess.com or calling Colorado Access at 303-751-9051 or 1-800-414-6198 if outside the Denver metro area.



State Managed Care Network Customer Service
PO Box 17580 Denver, CO 80217-0580
Phone: (303) 751-9051
Toll Free: 1-800-414-6198
Send claims to:
CHP+ Claims
PO Box 17470
Denver, CO 80217-0470