Children's Community Health Plan Provider Portal

Welcome to the Children's Community Health Plan Provider Portal. As one of our providers, we want you to have the resources and support you need to provide the best possible care. Our portal offers quick and easy access to updated information about member eligibility, claims, prior authorizations, and more.

Auto Authorization Request Tool

MAINTENANCE UPDATE - Maintenance will occur on the third Saturday of each month starting January 16, 2016. Maintenance should take no longer than 3 hours between 2:30 a.m. and 5:30 a.m. During this time, access to CareWebQI will not be available. If additional time is required, separate prior notification will be given. Visit our Maintenance Schedule to see a list of our upcoming maintenance dates.

CareWebQI - This prior authorization tool allows access to submit prior authorization requests, receive a reference number, an approval or review notification immediately.

Navigate Auto Authorization Tool

Claims Look-up Tool

Emdeon - The provider claims look-up tool quickly looks up member eligibility for the previous 12 months, claims status and claims appeals.

Navigate Emdeon Claims Look-up Tool

Important Updates

Fax option going away 

As of January 15, 2016, the fax number will no longer be available for inpatient admission notifications and prior authorization requests. Network providers can submit electronically using the CareWebQI auto-authorization tool via our portal. Learn more.

Don't forget to Submit!

Once you have completed your authorization request, please do not forget to click on the Submit button to initiate our authorization process.

Claims Appeals Update

We are updating the Claim Appeal feature, and it’s not available at this time. For help with your claims appeals, please contact our Customer Service Center at 800-482-4010.

Contact

Claims-related, mail to:
Children’s Community Health Plan
Attn: Claims
P.O. Box 56099
Madison, WI 53705

Clinical-Related, mail to:
Children’s Community Health Plan
Attn: Clinical Services-UM Department
P.O. Box 1997-6280
Milwaukee, WI 53201-1997
 

 

Portal registration questions
414-266-5747

 

Claims, clinical & general questions 800-482-8010

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