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Child Health Plan Plus Providers Making a Difference for Colorado's Children
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CHP+ Managed Care Network Provider Directory

Members and Families


Health Care Providers and Staff

CHP+ Managed
Care Network
Fee Schedule
& Reimbursements
Claims Submission
& Billing
Referrals
& Authorizations
Behavioral
Health Services
Pharmacy
Dental
HMO's
Request a CHP+
Provider Contract
Request
Provider Training
Provider
Newsletter
Provider
Materials
Health Care Providers & Staff

Provider Updates and CommunicationsGet Adobe Reader
Click here for Fluoride Varnish Resource Sheet.
Click here for Oral Health Preventive Care Toolkit.
Click here for Essential Community Provider (ECP) Certification Information.

  • Click here for the Application Form
  • Click here for the FAQs
Click here for CHP+ Retro Eligibility Claim Processing Guidelines.
Click here for Childhood Immunization Services provided by Colorado Local Public Health Agencies.

Benefit ChangesGet Adobe Reader
Click here to download the updated member Grievance and Appeal procedures.
Click here to download the SMCN Copay Increase table.

Provider ManualGet Adobe Reader
Click here to download the CHP+ Provider Manual.

Provider QuestionnaireGet Adobe Reader
Click here to download the Provider Questionnaire. The purpose of this questionnaire is to have the most accurate and up- to-date information to ensure you receive reimbursement in a timely
manner. Please complete and return this questionnaire with your signed contracts. Thank you

CHP+ Notification of Other Insurance FormGet Adobe Reader
Click here to download the CHP+ Notification of Other Insurance Form. Note: This form is for CHP+ provider use only and should be used when a current CHP+ member is also enrolled in another health insurance program.

CHP+ Add Baby Request Form
Use this form for clients who wish to add a member to their CHP+ policy (such as a newborn baby.)
Click here to go to the CHP+ Add Baby Request Form.

CHP+ Provider Address Change FormGet Adobe Reader
Please complete this form if your legal name, service location or your
taxpayer identification number (TIN) has changed and does not match your
current contract information.
Click here to download the CHP+ Provider Address Change Form.

CHP+ Provider Clinical Staff Update FormGet Adobe Reader
Please complete and submit this form to add or terminate a provider
from your practice or organization.
Click here to download the CHP+ Provider Clinical Staff Update Form.

CHP+ Provider Synagis Prior Authorization FormGet Adobe Reader
Please complete the Synagis Prior Authorization form and prescription and fax to Avella Pharmacy at 877-470-7604 for each patient.  Please indicate whether this will be administered in your office or the patient's home.
Click here to download the CHP+ Provider Synagis Prior Authorization Form.

CHP+ Materials
CHP+ has a wide range of free materials for distribution that contain helpful information for families interested in the programs. CHP+ offers applications, brochures and brochure holders, and posters for distribution and display across the state.
Click here to access the CHP+ site directly!

What you will need.

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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