BadgerCare Plus Transactions
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BadgerCare Plus Transactions

Claim Submission (837)

Electronic claim submission allows for standardized transmission of claims data, resulting in fewer rejections and more streamlined claims adjudication. To submit claims electronically, please complete an EDI set-up form. If necessary, work with your clearinghouse or billing service to arrange transmission.

Alternative claim submission option for either the 837 EDI or paper claim submission methods – SmartData Stream Clearinghouse Portal.

CCHP’s claim administrator, Dean Health Plan, has partnered with SmartData Solutions to offer claim submission by manually keying in the claim information and submitting them electronically through the SmartData Stream Clearinghouse Portal. There is no cost to providers or trading partners who submit their claims using this portal.  Rejected claims can be corrected and resubmitted through this portal tool. Register by contacting Smart Data Solutions at (855)297-4436. Our Payer ID is 39113

Claim Acknowledgement (277CA)

Electronic claims acknowledgement provides a claim-level acknowledgement of all claims received in the front-end processing system before claims are sent into our adjudication system. To engage in EDI transmission, please complete an EDI set-up form and, if necessary, work with your clearing house or billing service to arrange transmission.

In addition, the Confirmation Reports Portal is available to confirm claims submission and receipt. This Portal also gives you access to Notice of claim rejection.

Please work with your Provider Relations Representative at 844-229-2775 to set-up access to the Confirmation Reports Portal.

Claim Status Request & Response (276/277)

Electronic claim status (for claims accepted for adjudication) is available to providers via EDI transactions as well as through Change Healthcare Clearinghouse Portal. Requests allow real—time inquiry and response. Please note, providers should wait a minimum of 30 days after claim submission to send a claim status response to allow for the known payment processing time. To engage in EDI transmission, please complete an EDI set-up form and, if necessary, work with your clearinghouse or billing service to arrange transmission. A Provider Relations Representative can help you enroll.

Claim Remittance Advice (835) & Electronic Funds Transfer (EFT)

CCHP’s claim administrator, Dean Health Plan, partnered with Change Healthcare to provide the electronic remittance advice (ERA) as an alternative to the printed explanation of payment (EOP) as well as Electronic Funds Transfer (EFT) which allows providers to receive payments electronically. To learn more or sign up, see Change HealthCare Enrollment Services webpage. Our Payer ID is 39113

Eligibility Request & Response (270/271)

The most accurate way to confirm a member's benefits and coverage amounts is to submit an eligibility request transaction. CCHP’s claim administrator, Dean Health Plan, offers this transaction in real-time through traditional EDI as well as through Change Healthcare Clearinghouse Portal which can be accessed through CCHP’s Provider Portal. To engage in EDI transmission, please complete an EDI set-up form, if necessary, work with your clearinghouse or billing service to arrange transmission.

Contact us

If you have questions related to EDI set-up, data content, or other EDI issues please contact the EDI help desk directly at edi@deancare.com or (800) 356-7344 ext. 4320.

For questions regarding claims and claims payments, please contact CCHP Customer Service at 800-482-8010

For questions about your participation with CCHP, please contact CCHP Provider Relations at 844-229-2775.

 

Medicaid

Children's Community Health Plan

PO Box 56099
Madison, WI 53705
1-800-482-8010

Together with CCHP

Children's Community Health Plan

PO Box 1997, MS 6280
Milwaukee, WI 53201
1-844-201-4672

 

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