Claims


Below you'll find claims information for the BadgerCare Plus and Together with CCHP plans, along with information on the National Correct Coding Initiative. 

BadgerCare Claims


Claims Submissions


Claims Mailing Address

Children’s Community Health Plan

P.O Box 56099
Madison, WI 53705


Submitting Corrected Claims

To allow our system to read and acknowledge corrected claims, please follow the instructions in CCHP’s Corrected Claim Submittal Guide.


Submitting Claim Appeals

Provider appeals must be submitted using CCHP’s Provider Appeal/Claim Review Request Form. Please send one form and supporting documentation per claim review request.

Mail claim appeals to:
 Children’s Community Health Plan
 PO Box 56099
 Madison, WI 53705


Electronic Claims Submission

  • Providers are encouraged to submit claims electronically.
  • EDI Payer number is 39113
  • Manually Key in claims and submit electronically through Smart Data Stream Clearing House Portal


Questions?

Questions 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.


Together with CCHP Claims


Paper Claims

Together with CCHP does not accept faxes for claims. Hand-written claims are also not accepted.

Paper Claims can be mailed to:
Together with CCHP
P.O. Box 106013
Pittsburgh, PA 15230-6013

Electronic Claims

You may file claims electronically through the vendor of your choosing.

Documents cannot be attached when sending claims electronically.

Together with CCHP EDI Payer number is: 251CC

Electronic Remittance Advice (ERA) and Electronic Fund Transfers (EFT) forms are available on the website.


Corrected Claims

  • CMS 1500 should be stamped as a corrected claim.
  • UB04: Corrected claims should be billed with the correct bill type.


Claims Appeals

CCHP does not accept claims or appeals via fax.

For questions regarding claims and Explanation of Payment (EOP), providers can chat online through the Together portal or contact:

Together with CCHP Provider Service
844-202-0117

After contacting customer service, please complete the Together with CCHP Provider Appeal / Claim Request Review Form.

Submit the form, along with copies of any supporting documentation to:
Together with CCHP
ATTN: Appeals Department
P.O. Box 1997, MS 6280
Milwaukee, WI 53201-1997


National Correct Coding Initiative

CCHP follows the National Correct Coding Initiative (NCCI) which was created by the Centers for Medicare and Medicaid. This initiative was created to stop improper coding which leads to incorrect payments.

Forward Health has implemented the NCCI to monitor all professional claims and outpatient hospital claims submitted with Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) for compliance with:

  • MUE (Medically Unlikely Edits), or units-of-service detail edits.
  • Procedure-to-Procedure detail edits.

MUE is the maximum units of service that a provider would claim for a single member on a single date of service for each code. Procedure-to-Procedure detail edits define pairs of codes that should not be claimed together on the same date of service.

If the claim is denied for either of these reasons, providers will receive an explanation of benefits on the remittance advice that it was denied because of NCCI.

Learn more here.