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Filing a Claim - BadgerCare

Claim Submissions - BadgerCare Plus

To allow for more efficient processing of your claims, we ask for your cooperation with the following:

  • When submitting claims use the correct and complete member number. Using the correct member number on the claim helps ensure correct and timely payment.
  • Children’s Community Health Plan requires providers file claims in a timely manner.
  • Claims must be submitted in accordance with the claim-filing limit outlined in your Provider Network Service Agreement.
  • CCHP does not accept faxes for claims.
  • All claims must have the providers’ NPI numbers and taxonomy codes on their claims. If the taxonomy on your claim is different than what is registered with the state, your claim will reject.
  • CCHP NPI and Taxonomy Billing Requirement Guide
  • Children’s Community Health Plan Taxonomy Quick Reference Guide
  • Children’s Community Health Plan asks that providers allow 45 days to pass from the date of the submission before calling to check the status of claims.

Claims Mailing Address

Children’s Community Health Plan


P.O. Box 56099


Madison, WI 53075

Electronic Claims Submission

The CCHP EDI Payer number is 39113

Submitting Corrected Claims

Submitting Claim Appeals

Children’s Community Health Plan
P.O. Box 56099
Madison, WI 53075

Electronic Data Interchange (EDI) Transactions

Electronic Data Interchange (EDI) - An array of electronic transactions is available to facilitate a more efficient experience for providers.  

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. In addition, the Confirmation Reports Portal is available to see the status of claim submission through the pre-processing compliance edits.

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

Claim Remittance Advice (835) & Electronic Funds Transfer (EFT)Children’s Community Health Plan’s (CCHP) claims administrator, Dean Health Plan works with Change Healthcare (formally Emdeon) to provide the electronic remittance advice (ERA) as an alternative to the printed explanation of payment (EOP).  Electronic Funds Transfer (EFT) allows providers to receive payments electronically. To learn more or sign up, see Change HealthCare Enrollment Services

Claim Status Request & Response (276/277)

Electronic claim status requests allow real-time inquiry and response. This transaction is available to providers via EDI transactions as well as through the Dean Health Plan’s claims look-up portal. Please note that the provider 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. Please work with your Provider Relations Representative to set-up access for the Emdeon claims look-up portal.

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. Dean Health Plan, CCHP’s claim administrator, offers this transaction in real-time through traditional EDI as well as through the claims look-up portal. 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.

Please work with your Provider Relations Representative to set-up access for the claims look-up portal. 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 or problems with auto authorizations, call CCHP Clinical Services department at 414-266-5707 or 877-227-1142, option 2.

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

 

All Rights Reserved.
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