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TPA Transition

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. 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 TPA transition communication, where can I see it? 
Will my provider portal login information change with the TPA transition?
  • Yes, there will be a new provider portal that will require you to login for claims, appeals, eligibility, and benefits. If you already have a Network Health provider portal username and password, use those to login. You will have a new login if you do not have an existing Network Health login.
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.
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.
When will I get access to the new provider portal?
  • We will communicate timing and processes for access to the new provider portal in the coming months. If you already have a Network Health provider portal username and password, use those to login. You will have a new login if you do not have an existing Network Health login. To ensure all your staff, including portal users, receive the most up-to-date information, please subscribe to our email communications.
Will you provide training for the new provider portal?
  • Yes, we will provide training and resources on topics such as submitting a claim, confirming claim submission, claim look-up, member and coverage lookup and appeals. 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 claims change?
  • Yes, we will communicate the new information in the coming months.
Will the phone number for customer service change?
  • Yes, we will communicate the new information in the coming months.
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, we will communicate the new information in the coming months.
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 that I don’t see listed, who can I contact?


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