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Professional

This page is intended for Professional providers and is categorized by provider type. The following providers must use the ASC X12N 837P 5010 Professional format when submitting electronic claims or the Professional claims option via the CHAMPS Direct Data Entry(DDE) screens.

 

Ambulance

Community Mental Health Services Programs/Prepaid Inpatient Health Plans (CMH/PIHP)

Medical Clinics

Physicians (MD & DO)

Ambulatory Surgical Centers (ASC)

Durable Medical Equipment (DME)/Medical Suppliers

Optical Companies

Podiatrists

Anesthesiologist Assistants

Family Planning Clinics

Optometrists

Private Duty Nurses (Individually Enrolled)

Certified Nurse-Midwives

Hearing Aid Dealers

Oral-Maxillofacial Surgeons

School-Based Services

Certified Nurse Practitioners

Hearing Centers

Orthotists and Prosthetists

Shoe Stores

Certified Registered Nurse Anesthetists (CRNA)

Independent Laboratories

Physician Assistants

Urgent Care Centers

Chiropractors

Maternal Infant Health Program (MIHP)

Physical Therapists

To access a resource click on the preferred file hyperlink.

Resources for all Professional Providers

 

Additional provider specialty-specific resources below


Ambulance


Community Transition Services (CTS)

As outlined in the policy bulletin, MSA 21-11,  CTS Agencies will be screened and enrolled in the Community Health Automated Medicaid Processing System (CHAMPS).  Additional CHAMPS Provider Enrollment Resources

  • Facility/Agency/Organization (FAO) Enrollment Instructions: PDF
  • Rendering/Servicing Enrollment Instructions: PDF

Durable Medical Equipment (DME)/ Medical Suppliers


Hearing Aid Dealers/Hearing Centers

  • Hearing Services and Devices New Provider and Policy Updates- PDFWebinar
  • October 11, 2022: Hearing and Audiology Webinar-PDF, Webinar

Physician

 

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