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Reminder: New requirements for CHIP providers

October 17, 2017

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This article was updated to include the training schedule below.


As previously communicated, 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.

Training available ? register today!

CHIP is offering training for all providers* who treat CHIP members. Implementation of the Electronic Provider Enrollment Application User Interface training is designed to explain how to satisfy the enrollment requirements and is conveniently offered through an Internet virtual classroom.

The training session will last approximately two hours and a PowerPoint presentation will be available to download for use during and after the session. Providers can choose from one of the following training sessions:

  • Monday, October 30, 2017, through Friday, November 3, 2017.
  • Monday, November 6, 2017, through Friday, November 10, 2017.
  • Monday, December 4, 2017, through Friday, December 8, 2017.

Each day offers a morning session from 9 a.m. to 11 a.m. and an afternoon session from 1 p.m. to 3 p.m.

Register now! Upon completion of your registration, you will receive a confirmation page with instructions on how to join the session and the available audio options.

*This training session does not apply to CHIP providers who are also Medical Assistance providers and are already enrolled.

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.

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