As previously communicated, on January 1, 2018, the Pennsylvania Department of Human Services (Department) implemented the Affordable Care Act provision that requires all providers who render services to Children's Health Insurance Program (CHIP) members be enrolled with the Department as a CHIP provider. Upon enrollment, the Department issues providers a Provider Reimbursement and Operations Management Information System (PROMISe) identification number. This PROMISe ID is required in order to receive payment for services rendered to CHIP members.
Note: All providers in the CHIP network need a PROMISe ID for each location in which they see CHIP members. In addition, every provider within a group needs a PROMISe ID for each location.
You can still register for your PROMISe ID!
Although the deadline has passed, you can still register for your PROMISe ID. Be sure to request the effective date be retroactive to January 1, 2018. Otherwise, the date of your application will become your effective date, which could result in a gap in claims payment. Register today to avoid denied claims for services rendered to CHIP members.
How this affects claims processing
Although there will be no change to our claims processing procedures, please be advised that any claims for services rendered to a CHIP member on or after January 1, 2018, that are submitted to Keystone Health Plan East by a non-enrolled provider (i.e., one without a PROMISe ID) will not receive payment.
Learn more
Visit the Pennsylvania Department of Human Services website to access the application, requirements, and step-by-step instructions related to the enrollment process.