Clear Health Alliance Provider Home

Providers

Welcome, providers!

Resources that help health care professionals do what they do best – care for our members.

At Clear Health Alliance (CHA), we value you as a provider in our network. That's why we’ve redesigned the provider site to make it more useful for you and easier to use.

COVID-19 Information from Clear Health Alliance


Clear Health Alliance is closely monitoring COVID-19 developments and how the novel coronavirus will impact our customers and provider partners.

Looking for the secure portal?


For services provided before the rollout of the new Statewide Medicaid Managed Care program, please visit the previous CHA provider portal.

For services provided after the new Medicaid plan rollout, please visit the Availity portal.

Don't have an Availity account?  Register for free now!

Need help with Availity? Learn more

Provider News


Important notice: HIPAA verifiers on fax documents

All faxes sent to Simply Healthcare and Clear Health Alliance (Simply) will need to have three HIPAA verifiers in order for authorizations to be processed.

Important Notice CAHPS Reminder

The CAHPS survey is conducted every year from February to June. The survey measures a patient’s experiences and perceptions of their medical care rather than measurable outcomes.

Subscribe to Encounter Notification Service

You may already be receiving some ENS reports from Simply and CHA but can receive so much more directly from ENS. You are highly encouraged to subscribe independently to ENS and reap the benefits of using the service.

Interactive Care Reviewer — prior authorization submission tip sheet

To reduce common errors and duplicate requests, when submitting prior authorizations, please follow these guidelines.

Important notice: Vision services vendor transition to iCare Health Solutions, LLC

Beginning January 1, 2021, iCare Health Solutions, LLC will be the statewide subcontractor providing medical and surgical vision services to Simply members.

Guidelines: Interim billing for inpatient hospital services.

For billing interim inpatient hospital stays that exceed 100 consecutive days, hospital provider claims must following the procedures in this provider bulletin.

Important notice: LogistiCare renamed ModivCare

As of January 4, 2021, LogistiCare Solutions, LLC, the nation’s largest provider of non-emergency medical transportation and our transportation provider for regions one through nine, has formally changed its company name to ModivCare Solutions, LLC.

Prior authorization requirement for outpatient procedures if done in the outpatient hospital setting (place of service 22/billing code 013)

Effective January 1, 2021, prior authorization requirements will be required for the following CPT codes if requested in the outpatient (OP) hospital setting.

Availity access


The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer.

At Availity you can:

Request authorizations.
Submit claims.
Confirm eligibility.

Don't have an Availity account?  Register free now!

Availity is your one-stop to complete your transactions

Featured Resources


Pharmacist looking at prescription bottle

Pharmacy information

Search for up-to-date drug information, including hundreds of brand-name and generic medications.

Excited Mom showing off baby’s ultrasound

Maternal Child Program

When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. We encourage all our moms-to-be to take part in the Taking Care of Baby and Me® program, a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.

 
Patient talking with counselor

Behavioral health provider

We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.

Provider tools & resources

Interested in becoming a provider in the Clear Health Alliance network?

We look forward to working with you to provide quality service for our members.