Information for Providers

Heath care providers can find information about Hillsborough County Health Care Plan (HCHCP) member eligibility, medical services covered by the plan, formulary information, referral and authorization requests, billing inquiries and information, a provider newsletter and links related clinical and educational sites.

Here, participating providers also can enroll prospective members online to facilitate patient care. The website also contains reference materials such as the provider guide and a quick reference formulary wall chart for providers. Information is available for the mandatory Patient Assistance Program.

Billing Information

Online Services

The ASI provider website, where you can look up claims status and eligibility, is Hillsborough County’s current third-party claims administrator. ASI is wholly owned by American Benefits Plan Administrator (ABPA) and includes other plans as well, which is why you will see the ABPA home page.
Obtaining a Login and Password
  • Obtain your login and password online
  • If you submit claims thorough an MSO, you will need to obtain access from your MSO
    • Your MSO must be or will need to be set up as account administrator
    • As the administrator they can give you access if you are contracted with them
  • If you submit claims directly to the ASI claims clearing house, Emdeon, or you are an MSO, you can obtain your own login
To begin, you should select Provider Login. First time users will be prompted to register now. You will need to enter your Tax Identification Number (TIN), a member ID, and claim number.
Additional Assistance
MSOs, or other providers who need to be set up as the account administrator, should email Gail Demeter or call her at (813) 666-6907.

 

Eligibility Verification

Online Services
There are two ways to determine whether a member is eligible for the Hillsborough County Health Plan:
  • Call (813) 272-5555
  • Visit the ASI provider website
    • ASI is Hillsborough County’s third-party claims administrator
    • ASI is wholly owned by American Benefits Plan Administrator (ABPA) and includes other plans as well, which is why you will see the ABPA home page
Obtaining a Login and Password
  • Obtain your login and password online
  • If you submit claims thorough an MSO, you will need to obtain access from your MSO
    • Your MSO must be or will need to be set up as account administrator
    • As the administrator they can give you access if you are contracted with them
  • If you submit claims directly to the ASI claims clearing house, Emdeon, or you are an MSO, you can obtain your own login
To begin, you should select Provider Login. First time users will be prompted to register now. You will need to enter your Tax Identification Number (TIN), a member ID, and claim number.
Additional Assistance
MSOs, or other providers who need to be set up as the account administrator, should email Gail Demeteror call her at (813) 666-6907.
 

Provider Guide: Updated Policies and Procedures

The Hillsborough County Health Care Plan (HCHCP) Provider Guide provides guidance to providers regarding HCHCP policies and procedures. The HCHCP Provider Guide became effective February 1, 2011. Providers should familiarize themselves with the changes.
  • The HCHCP Provider Guide became effective February 1, 2011 and was last updated August 21, 2017

Referrals/Pre-Authorizations

Review & Management

Visit KePRO, the Hillsborough County Health Care Plan’s utilization review and medical management vendor. In KePRO’s medical management system, you can enter referrals, request pre-authorizations and check on the status of existing referrals or pre-authorizations. If you are a first time user, you may need to register and set up an account.

Provider Enrollment Database