• US Legal Forms

Insurance Subrogation Format In Contra Costa

State:
Multi-State
County:
Contra Costa
Control #:
US-000279
Format:
Word; 
Rich Text
Instant download

Description

The Insurance Subrogation Format in Contra Costa serves as a structured legal tool for initiating claims regarding subrogation rights in insurance matters. This form allows insurance companies to pursue recovery of funds they have paid out due to losses caused by third parties. Key features of the form include sections for detailing the parties involved, jurisdiction, nature of the action, and general allegations related to the claim. Users are instructed to accurately fill in information such as the names of parties, relevant dates, and monetary amounts associated with claims. The target audience, which includes attorneys, partners, owners, associates, paralegals, and legal assistants, will find this form instrumental in handling disputes that involve uninsured motorist claims and recovery efforts. The clear format aids in presenting the legal basis for subrogation actions, making it easier for legal professionals to navigate cases that involve financial recovery through insurance. Proper usage of the form ensures compliance with federal procedural rules, and it helps establish a basis for court actions that may require declaratory judgments regarding insurance rights and liabilities. This structured approach enhances the efficiency of legal proceedings and supports the effective recovery of owed amounts.
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  • Preview Complaint for Recovery of Monies Paid and for Declaratory Judgment as to Parties' Responsibility and Subrogation
  • Preview Complaint for Recovery of Monies Paid and for Declaratory Judgment as to Parties' Responsibility and Subrogation
  • Preview Complaint for Recovery of Monies Paid and for Declaratory Judgment as to Parties' Responsibility and Subrogation

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FAQ

Contra Costa Health Plan (CCHP) uses Availity as our clearinghouse. You must register with Availity in order to submit EDI claims to CCHP. You may begin your registration process on the Availity site. The CCHP payer ID is CCHS.

Enroll in CCHP Medi-Cal | Contra Costa Health.

Contra Costa Health Plan (CCHP) is a county-sponsored health-maintenance organization (or HMO) that provides managed care for more than 200,000 people in the county.

CHP currently accepts and highly encourages electronic claims submission. Our Payer ID number is 95112.

Payer Name: Loyal American Life (Medicare Supplement)|Payer ID: 13193|Professional (CMS1500)/Institutional (UB04)Hospitals

The payer ID is generally five characters, but it may be longer. It may also be alpha, numeric, or a combination. The payer ID is often located on the back of the insurance card in the Provider or Claims Submission section.

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!

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.

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.

Claims Submission LINE OF BUSINESSADDRESS Medi-Cal California Health and Wellness Plan Attn: Claims PO Box 4080 Farmington, MO 63640-3835

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Insurance Subrogation Format In Contra Costa