The Children’s Community Health Plan BadgerCare Plus (BCP) Prior Authorization List and Codes includes services for which authorization may be required for our members. Before submitting your authorization request, please review the most recent list below for exclusions and other important information.
Submit Authorizations Online
Network providers should submit inpatient admission notifications and prior authorization requests online using the CareWebQI auto-authorization tool via our Provider Portal. Faxed authorization requests from network providers will be returned and then processed once they have been submitted online. CCHP only accepts supporting clinical documentation by fax.
Out-of-network providers must call CCHP's Clinical Services department at 877-227-1142 (option 2) for authorization requests.
The CareWebQI auto-authorization tool gives network providers the online capability to:
- Quickly submit an authorization request
- Receive a reference number, an approval or review notification immediately
- Provide concurrent review information for inpatient admissions
For questions or assistance with your authorization request, call:
Children’s Community Health Plan - Clinical Services Department
Toll-free: 877-227-1142, option 2
Local: (414) 266-5707
Affirmative Statement - Children’s Community Health Plan (CCHP) wants its members to get the best possible care when they need it most. To ensure this, we use a auto authorization process, which is part of our Utilization Management (UM) program. UM decision-making is based only on appropriateness of care and service, and existence of coverage. CCHP does not specifically reward practitioners or other individuals for issuing denials of coverage. Financial incentives for UM decision makers do not encourage decisions that result in underutilization.