As of September 20, 2018, providers will not be able to send this request through a secured message for transplant and mechanical cardiac support requests. View this release.
08/01/2018 Community Paramedics Release
Members will receive an initial visit with one of the Community Paramedics during their hospital stay to introduce themselves and explain the program. View this release.
Children's Community Health Plan has updated the Prior Authorization and No Prior Authorization lists for BadgerCare Plus - CCHP. View this release.
Effective July 1, 2018, a prior authorization is required for narcotic analgesics prescribed for all Commercial and Exchange members age 18 and older. Starting August 1, there will be a transition period for members already taking a quantity limit of less than 200 mg per day. This applies to Together with CCHP members not BadgerCare Plus - CCHP members. View this release
Children's Community Health Plan has updated the Authorization lists for BadgerCare Plus - CCHP and Together with CCHP. View the release.
06/01/18 New Telehealth Policy
Effective June 1, 2018, CCHP has implemented a telehealth credentialing policy. Please contact CCHP at 844-229-2776 to schedule an onsite visit. View the policy
NICU Notification: Effective June 1, 2018, providers need to create a separate authorization for NICU. Providers should create an authorization with the mother's ID for the baby's information. In the notes section, the provider enters the baby's date of birth, weight, gestational age, and documentation. CCHP will then create an episode with the baby temp ID and send you notification of new episode number via CareWeb message system in the original episode created using the mother's information. When looking to add clinical or verification of authorization please reference newly created baby episode as original NICU notification episode will have been canceled. Due to system constraints, CCHP will continue to use the temporary ID for the baby through the entire hospital stay. The baby will not be assigned a permanent ID until after discharge. When the baby is discharged, please make sure to message the Utilization Management reviewer by attaching clinical and messaging the discharge date. Please make sure to choose the right admission date and check to see the authorization was submitted. CCHP has created this guide to help providers submit this notification.
01/01/18 - Prior Authorization - Patient Admissions
Please review the Patient Admissions Notice.
12/29/17 - New Years Hours
Our offices will be closed on Monday, Jan. 1, 2018. We will reopen on Tuesday, Jan. 2 at normal business hours.
12/20/17 - Christmas Hours
Our offices will be closed on Monday, Dec. 25, 2017. We will reopen on Tuesday, Dec. 26 at normal business hours.
11/29/17 - Drug Testing for Substance Use Disorders and Chronic Pain Treatment
CCHP has completed a review, revision, and adoption of an updated Drug Testing policy.
11/17/17 - Thanksgiving Hours
Our offices will be closed on Thurs. Nov. 23, 2017. We will reopen on Fri., Nov. 24 at normal business hours.
11/06/17 Credentialing Notice
On October 6, Children’s Community Health Plan completed a review, revision, and adoption of CCHP Credentialing Policies and Procedures. View these policies and procedures on CCHP's credentialing page. Read the full notice here.
The policy Practitioner and Organization Provider Suspension, Termination, and Appeal Rights has been revised and clarified. Section III B. Clarifies the processes for imposing a summary suspension when there are potential issues of quality or safety (page 3). Section IV A and B lists circumstances that will result in Automatic Termination from CCHP’s practitioner network (page 4 and 5). Section IV C does provide for a process to request a waiver of automatic termination when the request is submitted along with written explanatory and supporting information to the Credentialing Committee (page 5).
Practitioners who are terminated from CCHP’s network for cause and are not provided a waiver of the termination by the Credentialing Committee are not eligible to reapply for participation in CCHP’s network for 24 months. The process and procedure for appealing a termination action by the Credentialing Committee, and for rendering an appeal decision has been clarified (pages 5-10).
11/01/17 - Synagis Enrollment Form
Synagis Season Respiratory Syncytial Virus Enrollment Form (2017 - 2018)
10/23/17 - CareWeb Upgrade
CareWeb will be migrating hosted applications and services to a new network segment in our data center. These activities are expected to have performance and availability impacts to all hosted interactive solutions, including CareWebQI AutoAuth and their supporting services.
Work will begin on Nov 11, 2017 at 5:00 p.m. CST and work is expected to be complete no later than Nov 12, 2017 at 1:00 a.m. CST (8 Hours).
Client IT Department Alert
- The IP address of our interactive solutions is going to change, but the URL will not. Check to make sure to update IPs if you are using IP filtering for CareWeb solutions.
- HL7 interfaces will not change, but HL7 traffic will not be flowing during this maintenance window. The channel will be restarted when the maintenance is complete.
To monitor this maintenance, navigate to http://status.mcg.com where you can see the status of our solutions and optionally subscribe to email updates.
10/16/17 - Open Enrollment Period
Open Enrollment runs November 1 - December 15, 2017. Unlike in years past, Open Enrollment will only be a six-week period. Your patients may ask you if you are a member of the network, please be aware if you are provider in our Together with CCHP network. Learn more here.
10/01/17 - ICD-10 CM diagnosis codes
On 10/01/17, the new ICD-10 CM diagnosis codes for 2018 become effective for service dates of 10/01/2017 and beyond. Please view the Auto Authorization Guide for support.
10/01/17 - NICU Notifications Faxed
Effective November 1, 2017, all NICU notifications must be submitted via the CCHP Auto Authorization tool. We will no longer accept faxed NICU notifications. This can be accessed through the CareWeb.
Please view the NICU Auto Authorization Guide if you have any questions on how to provide notification or an authorization request. If you need further assistance on how to attach documents, please call 414-266-5747.
07/01/2017 - Important Security Update
Please upgrade your TLS protocol to 1.1 or higher before July 22, 2017 to make sure your provider portal access will not be interrupted.
Please share the TLS Protocol letter with your IT staff.
04/01/17 - Goodbye fax! Hello Auto Auth Tool
Effective May 1, 2017, all clinical documents submitted, for any service that requires notification or prior authorization, must be attached to our auto auth tool. Faxing will no longer be accepted.
Please read the announcement for more information.
01/01/17 - J Codes Requests
Effective immediately, please fax J-code requests directly to 844-201-4675.