Provider secure website
We're dedicated to providing great service to our providers and our members. That's why our HIPAA-compliant website is available 24 hours a day. The website supports the functions and access to information related to:
- Member eligibility search – Verify current eligibility of one or more member.
- Panel roster – View the list of members currently assigned to the provider as the PCP.
- Claims status search – Search for provider claims by member, provider, claim number, or service dates. Only claims associated with the user’s account provider ID will be displayed.
- Remittance advice search – Search for provider claim payment information by check number, provider, claim number, or check issue/service dates. Only remits associated with the user’s account provider ID will be displayed.
- Provider prior authorization look up tool – Search for provider authorizations by member, provider, authorization data, or submission/service dates. Only authorizations associated with the user’s account provider ID will be displayed.
- The tool will also allow providers to:
- Search prior authorization requirements by individual or multiple Current Procedural Terminology/ Healthcare Common Procedure Coding System (CPT/HCPCS) codes simultaneously.
- Review prior authorization requirement by specific procedures or service groups.
- Receive immediate details as to whether the codes are valid, expired, a covered benefit, have prior authorization requirements, and any noted prior authorization exception information.
- Export CPT/HCPS code results and information to Excel.
- Make certain staff works from the most up-to-date information on current prior authorization requirements
- Submit authorizations – Submit an authorization request online. Three types of authorization are available:
- Medical Inpatient
- Durable Medical Equipment – Rental
- Healthcare Effectiveness Data and Information Set (HEDIS®) – Check the status of the member's compliance with any of the HEDIS measures. A “Yes” means the member has measures that they are not compliant with; a “No” means that the member has met the requirements.
Log-in for the secure web portal.
Ver the provider portal navigation guide.
You may go to CHAMPS login to verify eligibility.