Claim For Subrogation In Contra Costa
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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.
Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.
Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.
If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.
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Submitting Claims Claims received after 180 days will be denied for untimely filing.
Send your claim form and documentation to: Mail: HealthSmart Benefit Solutions, Inc. PO BOX 1014 Charleston, WV 25324-1014 Fax: 806.473. 2535 Online: healthsmart/nysut.
CLAIMS DEPARTMENT PO Box 30755 Salt Lake City, UT 84130-0755. 1-800-333-8724.
Paper Claims Submission Please send your paper claims to: CCHP Claims Department, Post Office Box 1599, San Leandro, CA 94577.
Claims Submission LINE OF BUSINESSADDRESS Medi-Cal California Health and Wellness Plan Attn: Claims PO Box 4080 Farmington, MO 63640-3835
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!
CCHP is the primary managed-care provider for Medi-Cal beneficiaries in Contra Costa and we also manage smaller plans for county employees and IHSS homecare workers. Our members have access to hundreds of family medicine doctors and specialists in our provider networks.
Please send your paper claims to: CCHP Claims Department, Post Office Box 1599, San Leandro, CA 94577.
