Payer Types
CHIP
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
States run CHIP as Medicaid expansions, separate programs, or combinations, which determines whether CHIP obligations ride on Medicaid infrastructure or stand alone. The pediatric benefit mix (therapies, behavioral health, DME) shapes CHIP's prior-auth volume profile.