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.
Updated Information from the State effective July 1, 2010
Newborn Hospitalization Billing
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:
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
If applicable:
- 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 website at www.coaccess.com or calling Colorado Access at
303-751-9051 or 1-800-414-6198 if outside the Denver metro area.
|
