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  • Form B1 - Cchp

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Form B1 Employee Disenrollment Notice Fax to CCHP Sales Department (415) 955-8819 GROUP INFORMATION Group Name Group Number Please TERMINATE the following member(s) Disenrollment effective date (last.

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By Mail: CCHP Member Services, 445 Grant Avenue, San Francisco, CA 94108.

Paper Claims Submission All paper claims must be submitted using a CMS 1500 form (for professional providers) and a UB-92 form (for institutional providers). Please send your paper claims to: CCHP Claims Department, Post Office Box 1599, San Leandro, CA 94577.

Contra Costa Health Plan (CCHP) is an HMO, or health maintenance organization. HMOs cover health services provided by a network of specific doctors and providers. In Contra Costa County, CCHP is the primary managed-care plan for people with Medi-Cal. You must first enroll in Medi-Cal to become a CCHP Medi-Cal member.

1-877-661-6230 Call if you have a medical problem or if you have a medical question. The Advice Nurse can tell you if you need to go to urgent care or the emergency room, give you self-care instructions, schedule a telehealth appointment with a doctor, and more!

Our Products. Balance offers Individual & Family Plans (inside and outside Covered California exchange) and Employer Group Plans for businesses large and small. We compete directly with major health insurance companies by offering the right-sized, personalized alternative for healthcare coverage.

The CCHP payer ID is CCHS.

At CCHP, under the Balance by CCHP brand name, we offer plans focused on health, wellness, and preventive services, integrating Western and Eastern remedies to individuals, families, and employers of all sizes, and participate in the Covered-California marketplace.

Submitting Claims The claim submission timeframe for Contra Costa Health Plan is 180 days from the date of service, or primary explanation of benefits (EOB), for both contracted and non-contracted providers. Claims received after 180 days will be denied for untimely filing.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232