Authorizations

Effective February 1st, 2018, CCHP will not reconsider services, procedures and inpatient stays that CCHP has not received notification for from the provider. Please reference your provider agreement with CCHP that outlines providers are required to notify CCHP within 24 hours of an inpatient admission; and prior authorize elective services and/or procedures prior to providing services.

Please make sure to attach clinical to the request within 24 hours. Without clinical to review for medical necessity, your request for services may be denied.

• We recommend that you check each day for authorizations that are in the draft status and have not been submitted.
• CCHP will not be notified until the authorization has been submitted
• You can check by filtering the submission status to draft

Together with CCHP

Out-of-network providers for Together with CCHP need to call 844-450-1926 for instructions on submitting their requests.

• Prior Authorization List and Codes (2017 / 2018)
• No Prior Authorization List (2017 / 2018)
• Non-Covered Codes (2017 / 2018)
• Pharmacy Prior Authorizations

BadgerCare Plus

Out-of-network providers for BadgerCare Plus must call CCHP's Clinical Services department at 877-227-1142 (option 2) for authorization requests.    

• Prior Authorization List and Codes
• No Prior Authorization List

Helpful Link:

• Referral policies

Submission Guides:

• Behavioral Health Authorization Request Process
• CareWeb QI Auto Authorization Tool 
• Inpatient Authorization Request
• NICU Notification
• How to submit a Synagis Prior Authorization Request