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CHP+ Managed Care Network Provider Directory

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Health Care Providers & Staff

Claims Submission & Billing
We encourage you to bookmark CO.gov/HCPF/FutureCHP and check back often as HCPF will regularly update this page. Also, we encourage you to subscribe to our Future of CHP+ updates here.

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.


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-10)
  • 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 Tool Kit website at www.coaccess.com/for-providers 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