Click here for Essential Community Provider (ECP) Certification Information.
Click here for CHP+ Retro Eligibility Claim Processing Guidelines.
- Click here for the Application Form
- Click here for the FAQ's
Click here for Childhood Immunization Services provided by Colorado Local Public Health Agencies.
Click here for information regarding the expansion of CHP+ offered by Colorado Access into El Paso and Teller counties.
Click here to read the benefits changes that are effective January 1, 2013.
Click here review the Prenatal program's Income Eligibility policy change.
Click here to download the updated member Grievance and Appeal procedures.
Click here to download the Mental Health Respite Care Letter.
Click here to download the Presumptive Eligibility Prenatal Inpatient Coverage Letter.
Click here to download the SMCN Copay Increase table.
Click here to download the CHP+ Provider Manual.
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
Click here to download
Frequently Asked Questions regarding the transition of administrative services to Colorado Access.
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.
Use this form for members who need to be added into the eligibility and enrollment system. Click here to download the CHP+ Add Member Request Form. Note: This form is for CHP+ provider use only.
Use this form for clients who wish to add a member to their CHP+ policy (such as a newborn baby.)
Click here to download the CHP+ Add Baby Request Form.
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.
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.
Please complete the Synagis Prior Authorization form and prescription and fax to US Bioservices 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.
Click here to download the CHP+ Provider Synagis Prior Authorization Clinical Criteria.
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!
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