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TPA Transition

New claims & customer service administration

New Third-Party Administrator (TPA)

We are excited to share the news of our partnership with a new Third-Party Administrator (TPA) for our Medicaid line of business' claims and customer service administration. Starting January 1, 2026, Chorus Community Health Plans (CCHP) customer service and claims administration services will be administered by Network Health. CCHP is committed to providing quality customer service and claims processing though our TPA, and we are excited to provide these services to our provider partners powered through a highly rated organization in Network Health.

FAQ

I didn't receive the initial TPA transition, new claims and customer service administration, communication, where can I see it? 
What was included in the September 16, 2025, TPA transition, new claims and customer service administration, communication?
  • A new payer ID and contact information has been established for use on Medicaid claims and inquiries beginning December 15, 2025. View the email communication here. 
What was included in the October 14, 2025, TPA transition, new claims and customer service administration, communication? 
Will my provider portal login information change with the TPA transition?
  • Yes, there will be a new CCHP Provider Portal that will require you to login for claims, appeals, eligibility, and benefits. If you have an existing Network Health Provider Portal username and password, use those credentials to login. 
  • If you DO NOT have Network Health login, then you will need to register. 
What is the link for the new CCHP Provider Portal?
Is this new portal the same as the GuidingCare Authorization Portal?
  • No, the new provider portal is for claims and appeals. You will continue to use the GuidingCare Auth Portal for pre-authorizations.
Is there a document that explains the process to register for the new CCHP Provider Portal?
I already have login credentials for the Network Health Provider Portal, do I need to register again for the CCHP Provider Portal?
  • No, users who already have existing Network Health Provider Portal login credentials do not need to create a new account. Your existing Network Health login will work on the CCHP Provider Portal, login.chorushealthplans.org.
I'm having issues registering for the new CCHP Provider Portal, who do I contact? 
I don't see the claim or member information in the new CCHP Provider Portal?
  • Information prior to December 15, 2025, may be missing and/or incomplete or inaccurate as we are still inputting data into the new portal.
  • For day-to day business now through December 14, 2025, continue to use the current provider portals for Medicaid claims, eligibility and benefits.
Will the GuidingCare Auth Portal change?
  • No, you will continue to use the GuidingCare Auth Portal for pre-authorizations. If you have access to this portal, it will not change.
  • If you have questions with the existing Authorization Portal, you can reach out to the GuidingCare team at CCHP-PortalReg@chorushealthplans.org
Will you provide training for the new CCHP Provider portal?
  • Yes, there will be training and resources available on topics such as submitting a claim, confirming claim submission, claim look-up, member and coverage lookup and appeals. We’ll communicate training opportunities via email. We’ll communicate training days/times via email. To ensure all your staff, including portal users, receive the most up-to date information, please subscribe to our email communications.
What if my schedule doesn’t allow me to attend a training session?
  • Look for communications with details on how you can access training materials.
Will the mailing address for paper Medicaid claims change?
  • Yes, beginning December 15, 2025, the new mailing address is:
  •  Chorus Community Health Plans
  • PO Box 359
  • Menasha, WI 54952-0359
  • PRIOR TO DECEMEBR 15, 2025, ANY MEDICAID CLAIMS SUBMITTED TO THE NEW PO BOX WILL NOT BE ACCEPTED OR PROCESSED. 
  • For paper Medicaid claims now through December 14, 2025 continue using the current mailing address:
  • Chorus Community Health Plans
  • PO Box 56099
  • Madison, WI 53705
Will the phone number for provider customer service change?
  • Yes, beginning December 15, 2025, the new provider customer service phone number will be 877-458-1289.
  • From now until December 14, 2025, continue to use the current phone number, 800-482-8010.
What will be the process to submit an appeal after 1/1/26?
  • You will be able to submit an appeal through the new provider portal. Look for communications with details on appeals training.
Will the payer ID for electronic claims change?
  • Yes, beginning December 15, 2025, the new payer ID is 29123.
  • PRIOR TO DECEMEBR 15, 2025, ANY MEDICAID CLAIMS SUBMITTED TO THE NEW PAYER ID WILL NOT BE PROCESSED AND APPEAR AS A DENIAL.
  • For Medicaid claims now through December 14, 2025, continue using the current payer ID, 39113.
Will the electronic funds transfer (EFT) for Medicaid claims change?
  • Yes, we will communicate the new information in the coming months.
I have bookmarked pages on the CCHP website that I frequently use, will links change?
  • Possibly, we will be working on website updates to support the TPA transition as well as the IFP exit. There will be communications about website updates as we approach the 1/1/26 transition.
I have downloaded forms that I use all the time, can I still use these forms?
  • No, we suggest downloading an updated version of the form after 1/1/26 to ensure you have the most up to date form with accurate information.
I have additional questions about the TPA transition, new claims and customer service administration, that I don’t see listed, who can I contact?
I am looking for information on the 2026 Affordable Care Act (ACA) Marketplace/IFP exit.
  • Visit this page to find out more information on CCHP exiting the Individual and Family Plan (IFP) market (also referred to as Marketplace, Exchange, ACA or Commercial) on December 31, 2025.

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