This form for use in litigation against an insurance company for bad faith breach of contract. Adapt this model form to fit your needs and specific law. Not recommended for use by non-attorney.
Complaint Subrogation Sample For Insurance In Contra Costa
Category:
State:
Multi-State
County:
Contra Costa
Control #:
US-000279
Format:
Word;
Rich Text
Instant download
Description
Free preview
Form popularity
FAQ
Providers or the general public can contact Provider Relations at: providerrelations@cchealth or by calling 1-877-800-7423 option 6.
Contracting and non-contracting providers can contact Utilization Management at 1-877-208-4959 to request to obtain prompt authorization.
Contra Costa Health Plan offers managed care to Medi-Cal beneficiaries in Contra Costa County.
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!
Submitting Claims Claims received after 180 days will be denied for untimely filing.
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.
The complaint involves a plan's decision to invoke an extension relating to an organization determination or reconsideration. The grievance involves a refusal by the plan to grant an enrollee's request for an expedited organization determination or expedited reconsideration.
Congressman Mark DeSaulnier (DE-SOWN-YAY) proudly represents California's 10th Congressional District, which includes much of Contra Costa County and a part of Alameda County.
Paper Claims Submission Please send your paper claims to: CCHP Claims Department, Post Office Box 1599, San Leandro, CA 94577.