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.
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:
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.
- Issues ID Cards
- Processes Claims
- Provider Network Management
- Pre-authorization services
- Quality Program Administration
You can access www.coaccess.com for more
information on Colorado Access.
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:
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
- 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
- The insurer's name (CHP+)
- Provider's tax ID
- Provider's billing address
- Accident information
- Number of units of service
- Authorization number
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.
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.