Chorus Provider News
Optum - Change Healthcare outage and payment service update
Optum - Change Healthcare (CHC) is our vendor to print checks, provide electronic explanation of payments (EOPs), and for coordination with banks for claim payments. CHC, a subsidiary of UnitedHealth Group, is experiencing a cyber-security issue.
Once we became aware of the outside threat, in the interest of protecting our partners and members, we took immediate action to disconnect our systems to prevent impact. Click here to stay informed of the situation. UnitedHealth Group is providing regular updates on a newly launched website. For additional information, please read our FAQ guide.
To mitigate the issue and minimize further financial impacts to our providers, starting April 10, 2024, we’re switching from Change Healthcare to InstaMed for payment services.
InstaMed registration information:
- If you are already registered with InstaMed from any payer, you’re already set up to start receiving payments through Instamed.
- If you are not registered, InstaMed will issue paper checks.
- If you would like to avoid paper checks, please see below on how to register with InstaMed.
Claims submissions
The cyber-security issue has impacted how CCHP receives claims. Please click the button below to learn how to submit electronic and paper claims for our Medicaid and Individual and Family Plan lines of business.
Provider Portals
Guiding Care Prior Authorization Portal
- As of March 2024, CareWeb has been replaced by the Guiding Care Auth Portal. No authorizations will be accepted in CareWeb and will need to be submitted in Guiding Care. View additional information here.
BadgerCare Plus Claims Look-up Tool
BadgerCare Plus Claims Submission Tool
BadgerCare Plus Claims Confirmation Tool
User Guides
Guiding Care Login Instructions:
- For those who do not work at Children's and are not a Children's Outlook user, use this instructions guide
- For those who work at Children's and are a Children's Outlook user, use this instructions guide
BadgerCare Plus Claims Registration Guide
BadgerCare Plus Claims User Guide
BadgerCare Plus Claims Confirmation User Guide
Sign up for InstaMed
Medicaid claim payments through InstaMed
We are making payments for Medicaid claims through InstaMed. To sign up to receive Electronic Fund Transfers (EFT) Medicaid payments and Electronic Remittance Advice please use the links below.
Providers are encouraged to use the online registration solution, however providers can also contact InstaMed’s network development team at 866-945-7990 to register.
Important information:
- Medicaid EFT Payments: EFT payments will temporarily indicate they are from Medica or Dean Health Plan. Please check the first claim on the remit to confirm it is a CCHP or Care4Kids (C4K) remit. The remits will only have CCHP or C4K member payments and will not be combined with Medica or Dean Health Plan members. In most cases a unique identifier is returned to a provider when submitting electronic claims. This unique identifier will be sent back on the remit and automatically post correctly with CCHP as the payer. If there is not a unique identifier it is recommended to check the first claim on the remit to confirm the file posted to the correct payer. Please contact CCHP Provider Services at 1-800-482-8010 with any questions regarding claim payments.
- Medicaid Paper Checks: Paper checks and paper remits received will temporarily indicate they are from Medica or Dean Health Plan. Please check the first claim on the remit to confirm it is a CCHP or Care4Kids (C4K) payment and remit. The remits will only list CCHP member payments and will not be combined with Medica or Dean Health Plan members. Please contact CCHP Provider Services at 1-800-482-8010 with any questions regarding claim payments.
We are working on removing the reference to Medica and Dean and replacing it with CCHP. We do not have a timeline for this change. We will provide updates as we learn more.
New Provider Auth Portal
Guiding Care important information
CCHP has launched a new Provider Authorization Portal through Guiding Care. No authorizations will be accepted in CareWeb and will need to be submitted in Guiding Care.
Guiding Care updates:
- Have you watched the training videos and read the how-to guides? We have many resources available to you here.
- On 5/3 we sent an update regarding our authorization portal incorrectly reading dates for services which has led to improper processing and denial of some claims. Unfortunately, we have continued to face these issues. Our team is working hard to correct this promptly and we will send an update when the issue has been resolved. As a reminder, you are still able to submit authorizations in the meantime and please do not appeal these claims as they will be reprocessed.
Thank you for your ongoing partnership in providing high quality care to our members!
A Healthcare Network Committed to Caring
Chorus Community Health Plans (CCHP), an affiliate of Children’s Wisconsin, is an HMO dedicated to providing access to the highest quality health care and services to our members living in Wisconsin.
Chorus Community Health Plans is a member of the Association for Community Affiliated Plans (ACAP), which is a national trade association representing more than 70 nonprofit safety net health plans in 28 states. ACAP’s mission is to represent and strengthen not-for-profit, safety-net health plans as they work in their communities to improve the health and well-being of vulnerable populations.
Recredentialing Notice for Wisconsin Health Insurance Providers
To assist practitioners with the challenges to timeliness during COVID, CCHP had extended the recredentialing cycle by two months, going from 36 months to 38 months during the Public Health Emergency (PHE). With the PHE set to expire in May 2023, CCHP will return to the 36 month cycle as designated by law, therefore any practitioner who does not submit their completed recredentialing application within the cycle will be terminated.
APNP – Collaborative Agreement
In compliance with the executive order during the Public Health Emergency, CCHP had waived the collaborative agreement requirement for APNPs. With the PHE set to expire in May 2023, CCHP will once again require a Collaborative Agreement per Wisconsin State law. APNP’s without a collaborative agreement by May 18, 2023 will receive a summary suspension of their network privileges.
Provider Education
Here you'll find helpful links to information you need to work with us more efficiently, so you can spend less time on administrative tasks and more time providing outstanding care to our members.
Stay Connected
Chorus Community Health Plans sends updates through the mail, email and in our provider newsletter. If you would like to start receiving email communications from us, please complete our newsletter email opt-in form.