Network Provider FAQs

How does The CHP Group advocate for complementary & alternative medicine?
We meet regularly with local, state, and federal representatives in order to promote the benefits of complementary and alternative medicine. We also provide public comment and testimony related to CAM in health care reform whenever the opportunity is present.

How can CHP help me improve my billing?
CHP offers FREE workshops to contracted providers and their office staff. These workshops focus on billing procedures for CHP and our contracted health plans as well as industry standard information.

How is care managed?
CHP prefers to leave treatment decisions in the hands of the provider and their patients. We primarily rely on achieving accountability through sharing objective and actionable information with you about your practice obtained from submitted claims data.

Does CHP require medical referrals?
CHP advocates for direct access to CAM providers. Most of our patients go directly to their provider of choice without the need for a primary care provider (PCP) referral. We believe that this is the most efficient way for patients to access care. CHP also provides access to PCP-referred patients in certain contracts.

Will CHP perform chart reviews and onsite audits?
Our clinical record keeping quality standards are derived from CHP provider input and authoritative sources including educational standards, state and federal regulations, health care industry standards, and consensus of professional peers. CHP is transparent regarding quality criteria and the assessment of processes. We believe that high-quality clinical care is reflected in high-quality clinical documentation. We assist our providers in clinical recordkeeping best practices and provide education via our eJournal on a regular basis.

Site visits are conducted randomly. Facility review is conducted by both attestation (the Office Facility Questionnaire (OFQ)) and in-person site visits by CHP staff. Quality criteria for office facilities are driven by professional and industry standard criteria. Site visits are announced in advance. They are intended to assure our health plan partners and your patients that your office environment is professional, accessible, confidential, and safe. The criteria are explicit and readily available; our intent is to help you improve the quality of your facility.

Where can I find information about how to submit my claims?
Network providers can access CHP’s current Billing Manual at www.chpgroup.com behind the secure Provider Log-in. Network providers and/or their office staff can log-in to the secure provider portal from our home page.

Does CHP have specific trading partners for electronic claims submission?
Yes. CHP is currently contracted with Office Ally and HealthSmart. To obtain CHP’s payer code for these entities, please contact the CHP Claims & Customer Service Department at 503-203-8333 or refer to the CHP Billing Manual.

Can I sign up to receive claims payments via Direct Deposit?
Yes, CHP offers Direct Deposit to all network providers. The Direct Deposit form and instructions can be found on our website at www.chpgroup.com, behind our secure Provider Log-in in the Frequently Used Forms section. Or you may contact the Provider Services Department to obtain a form:

  • By e-mail at providers@chpgroup.com
  • By phone at 503-203-8333 or 800-449-9479

Will I receive a Provider Remittance Advice from CHP?
Yes. A CHP Provider Remittance Advice is mailed weekly if you have claims processed on that cycle. If you see patients from more than one health plan that contracts with CHP, you will receive a Remittance Advice for each contracted health plan.

How do I notify CHP of a change of address or clinic information?
How can I change information in the Provider Directory or online Provider Search?
How do I nominate another provider to join CHP’s network?

Please contact the Provider Services Department by any of the following methods:

What is my username and password to log-in to CHP’s website?
Your username is your NPI Type I number. You were provided with a temporary password at the time of contracting. If you have forgotten your password, please contact the Provider Services Department by any of the following methods to have your password reset: