Authorizations

Important: Children's Community Health Plan has an updated Telehealth Policy in response to COVID-19. Please view the policy here.

Children's Community Health Plan will not reconsider services, procedures and inpatient stays that we have not received notification for from the provider. 

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 reference your provider agreement regarding inpatient admissions for more details.

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

You may contact the UM department from 8 a.m. to 5 p.m., Monday through Friday at 414-266-4155. Messages are confidential and may be left 24 hours per day. Communications received after normal business hours will be responded to on the following business day.

• 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

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