Thank you for the services you provide to members of Community Health Partnership, a program of Partnership Health Plan, Inc. (PHP) and Community Family Care (CHP-LTS).
Community Health Partnership, a program of Partnership Health Plan, Inc. (Partnership) is a Health Maintenance Organization (HMO) and a Special Needs Plan (SNP). It is the payer of acute and primary care, medical/dental and all long-term support services for Partnership members enrolled in the program.
Community Family Care (Family Care) is the payer of only long-term support, which includes limited Medicaid services such as outpatient therapies and DME/DMS for Family Care members enrolled in the program.
Additional details related to the covered services in each benefit package may be found in the Partnership Summary of Benefits and/or Evidence of Coverage documents or in the Family Care Member Handbook.
PLEASE NOTE: Coverage is always member-specific and based on individualized member need. As a general rule, all services require Prior Authorization by CHP unless your Provider Service Agreement, the Partnership Summary of Benefits/Evidence of Coverage, Family Care Member Handbook, or billing guidelines state otherwise.
Billing Procedures and Requirements
Please see link below to the billing procedures and requirements applicable to the member’s benefit plan. This information will be beneficial when submitting a claim for processing.
Provider Billing Procedures
Billing and Claim Form
In general, providers of Medicare/Wisconsin Medicaid services should bill claims utilizing the same codes and formats used for fee-for-service (UB04, CMS1500, etc.). Assisted Living providers are to bill CHP on the CMS 1500 form, pursuant to the Provider Billing Procedures. All other providers are strongly encouraged to utilize the CHP Standard Claim Form (see link below) rather than a provider-specific invoice in order to ensure timeliness and accuracy of claims payment.
CHP Standard Claim Form Instructions
Download the CHP Standard Claim Form here.
Third-Party Administrator
All coordination of benefits requirements apply. CHP’s third-party administrator is Security Administrative Services (SAS) in Marshfield, Wisconsin. SAS’s contact information is located on page 10 of the current billing procedures. Please note that all claims for covered benefit services to Family Care and Partnership members should be sent to SAS for processing.
As a CHP provider, your first point of contact for claims resolution is to call SAS at 1-800-548-1224. If you are unable to resolve your questions or concerns with SAS, you may contact CHP Claims Customer Service at 715-838-1720 and/or proceed with claims appeals processes as articulated in the Provider Bill Procedures.
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