Home Administrative Billing & Reimbursement BlueCard® Health and Wellness Medical PEAR portal Pharmacy Products Quality Management

New requirements for CHIP providers

September 5, 2017

The Pennsylvania Department of Human Services (Department) is implementing the Affordable Care Act provision that requires all providers who render services to Children?s Health Insurance Program (CHIP) members be enrolled with the Department as a CHIP provider by January 1, 2018. A letter detailing the enrollment process can be found here.

The appropriate application and all required documents must be submitted to the Department by November 1, 2017. This will allow for timely processing of all applications. CHIP providers who are already enrolled in the Pennsylvania Medical Assistance (MA) Program do not need to enroll again. However, if providers are enrolled with another state?s Medicaid or CHIP Program, they must enroll with the Department.

The following attachments, as referenced in the letter, are available to assist you with the enrollment process:

There will be no change to our claims processing procedure. However, beginning January 1, 2018, any claims submitted to Keystone Health Plan East by a non-enrolled provider for services provided to a CHIP member will not receive payment.

All applications, requirements, and step-by-step instructions are available on the Pennsylvania Department of Human Services website.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
Connect with us     Facebook     Twitter     Flickr     YouTube     Walk the Talk    Independence Pinterest    Independence LinkedIn    Independence Instagram Site Map        Anti-Fraud        Privacy Policy        Legal        Disclaimer
© 2023 Independence Blue Cross.
Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.