Network Support Services
The Capital Health Plan (CHP) Network Services Department is available to assist practitioners and facilities that provide service to CHP members. This section provides helpful information, newsletters, and forms.
Network News
Our provider newsletter, Network News, is published by Capital Health Plan Network Services. It has timely information relevant to your practice and your relationship with CHP, such as providing guidance, updates, and information. Network News can be accessed through CHPConnect.
Electronic Claims Submission
CHP currently accepts and highly encourages electronic claims submission. Our Payer ID number is 95112. You will need to follow the submission guidelines in our EDI Companion Guide. We also offer direct data entry of claims through CHPConnect. Through CHPConnect you are able to enter your claims data on an individual basis and eliminate paper submission. You will need to register on CHPConnect, if you haven’t already, to use this functionality. Non-contracted providers outside the state of Florida must submit claims to their local Blue Cross Blue Shield plan. If you have any questions, please call our Network Services Department at (850) 523-7361
Direct Deposit with PaySpan
PaySpan is health care’s leading provider of payment reimbursement solutions. The PaySpan network connects over 700 health plans with over 1.3 million provider payees and 107 million consumers. With the largest health care network in the U.S., PaySpan provides payment automation services that improve administrative efficiency, meet regulatory requirements, and allow providers to manage their reimbursements.
CHP has partnered with PaySpan to provide claim reimbursement and remittance advice for our providers. This free service electronically deposits CHP provider reimbursement payments to the bank account(s) of your choice via electronic funds transfer (EFT) and provides online access to Explanation of Benefits (EOBs) and payment reconciliation reports.
Follow the instructions below to set your practice up for PaySpan’s direct deposit:
- Register for your unique PaySpan registration code(s) online.
- Register for your unique PaySpan registration code(s) via email with Provider Support.
- Please use subject line “Registration Code Request – Capital Health” and include the Tax Identification Number for your practice in the body of the email. Your payments will be received via mail until you enroll in EFT.
- Once you receive your unique PaySpan registration code(s), you can then enroll in EFT.
For additional assistance, please visit PaySpan Support, email PaySpan Support directly, or call 1 (877) 331-7154 and press option 1.
Credentialing of Network Providers
Capital Health Plan is committed to providing CHP members in Leon and the surrounding counties with high-quality affordable health care. CHP verifies each practitioner’s or provider’s credentials to assess their ability to deliver care to our members based on criteria that include licensure, relevant training, conduct, and experience.
Initial credentialing is completed upon acceptance to be a part of the CHP network and re-credentialing is completed every three years thereafter.
Practitioners have specific rights related to the credentialing process:
- You have the right to be informed of the status of your credentialing application.
- You have the right to review information obtained through the verification process, although this does not apply to references, recommendations, or other information that is peer-review protected.
- You have the right to clarify or correct information on your application that is inconsistent with information obtained via primary source verification. CHP’s Network Services staff will contact you in writing if they identify an inconsistency in the information received through primary source verification. To clarify or correct information in your credentialing file, submit the correction in writing to CHP’s Network Services Manager within 10 business days from the date you viewed the information. CHP will review your submission and respond in writing within 30 days of receipt.
If you should have questions regarding the credentialing process or the status of your application, you can contact Network Services at (850) 523-7361 or by emailing Network Services directly. CHP will provide you with status within 10 business days.