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.
Submit all required documents now to allow for timely processing of your application. Once enrolled, you will be issued a Provider Reimbursement and Operations Management Information System (PROMISeTM) identification number from the Department, which is required to treat CHIP members. 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 ? ONLY ONE WEEK LEFT ? 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 following training sessions will last approximately two hours and a PowerPoint presentation will be available to download for use during and after the session.
Monday, December 4, 2017, through Friday, December 8, 2017
Choose either the morning session, which runs from 9 a.m. to 11 a.m. or the afternoon session, which runs 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:
- Attachment A: CHIP Provider Types and Specialties for Enrollment
- Attachment B: Provider Types Required to Obtain a Criminal Background Check
- Attachment C: Provider Types Required to Pay the Enrollment Application Fee
- Attachment D: Hardship Exception Request Form
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.