Insurance Subrogation Format 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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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
