Portal

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
    • Outpatient
    • 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.

Paper Register Form - Please complete and return this form in full to complete registration. This form is for the Secure Provider Web Portal. Or fax 1-844-300-7473 or email us.

Log-in for the secure web portal.

View the provider portal navigation guide.

You may go to CHAMPS login to verify eligibility.