Welcome to the Provider’s section of our Website. Community Health Partnership, Inc. (CHP) in association with our HMO Partnership Health Plan, Inc. and our MCO CHP-LTS, is pleased to be affiliated with more than 500 physicians, health care professionals, and facilities in west-central and western Wisconsin.
Whether you are a current provider for one of our program options or are thinking about being a CHP provider, you’ll find the information you need here.
Select an option below to obtain provider-specific information related to either of program options.
Community Health Partnership (HMO SNP), a Program of Partnership Health Plan, Inc. is managed by Partnership Health Plan, Inc. (PHP), a legal Health Maintenance Organization (HMO) created by Community Health Partnership, Inc. Through an Administrative Services Agreement, all administrative and management services are provided to PHP by Community Health Partnership, Inc.
Community Family Care is managed by CHP-LTS, Inc, a legal Managed Care Organization (MCO) entity created by Community Health Partnership, Inc. Through an Administrative Services Agreement, all Administrative and management services are provided to CHP-LTS by Community Health Partnership, Inc.
The majority of consumers utilizing Community Family Care's services are adults currently served in our five-county area. Community Family Care's goal in provider network development has, and continues to be, to seek collaborative partners who are interested in providing quality services to our members and support the goals each member and their team have defined in their individual service plan. We are interested in talking with you to help us meet this goal.
The Provider Application/Change Form is a required document to be completed and returned to CHP in order to notify us of provider changes, or to begin the initial review process of requesting inclusion into either or both programs as a network provider.
Process of Selection and Inclusion for Qualified Providers
CHP receives and reviews all requests for the inclusion of a Provider into its provider network via the Provider Application/Change Form. The process includes an assessment of the current network to determine if there is the need for an additional provider in any identified specialty or geographic area. Upon determination, the applicant will be notified by the Provider Relations department within 30 days from the receipt of the application on any decisions. A Contract Specialist from the Provider Relations department is assigned to the provider applicant and will then perform the following steps:
- Initiates contact with the potential provider and arranges for a face to face contact to assess the facility or service
- Provides the provider with details of the Programs, including mission, vision and philosophy
- Reviews requirements and expectations of network providers
- Reviews the payment structure for services provided
- Reviews the terms of a sample copy of a Service Agreement, as appropriate
- Upon completion of the initial interview process CHP gathers information in accordance with credentialing policies to verify the provider is a qualified candidate
- Upon satisfactory completion of verification of credentials, the potential provider is approached for a final decision about joining the network
- Upon receiving an affirmation of interest, CHP proposes and negotiates the terms of a Service Agreement
- Upon a full execution of the Service Agreement the Plan Provider is added to the applicable network Provider Directory and Provider Database
If an applicant is denied inclusion into the provider network, the applicant will be notified by the Provider Relations department within 30 days from the receipt of the application with a letter stating the basis for the decision and your appeals rights.
Notification of Changes
Provider change notifications are recorded on the Provider Application/Change Form. To assure CHP has accurate and the most current information, it is the Plan Provider's responsibility to submit written documentation to CHP for notification of any of the following changes:
- Address/telephone number
- Tax identification number
- Office manager/contact person
- Office location
- Name changes
- Retirement of Provider
- Office hours
- Provider moving out of state
- Liability insurance
- New provider
- Malpractice insurance
- Provider coverage
- Scope of practice
Our Program Benefit Summary outlines a complete listing of benefits and services available through our Partnership and Community Family Care programs.
Provider Bulletin is a quarterly newsletter with the purpose of updating our providers on policy and procedure changes, information about claims processing, and other general provider issues.
CONTACT INFORMATION - For more information regarding our provider network, please feel free to contact us at 715-838-2900 and ask for the Provider Relations department.
Community Health Partnership, Inc.
Provider Relations Department
2240 EastRidge Center
Eau Claire, WI 54701
715-858-2900
Toll Free 800-842-1814
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