• US Legal Forms

Subrogation Form In Medical Billing In Contra Costa

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

Description

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.

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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

Timely filing is when an insurance company put a time limit on claim submission. For example, if a insurance company has a 90-day timely filing limit that means you need to submit a claim within 90 days of the date of service.

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 must be submitted within 12 months of the date of service. If multiple services are performed on the same day, include all services on one claim.

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.

Contracting and non-contracting providers can contact Utilization Management at 1-877-208-4959 to request to obtain prompt authorization.

You can also email us at portal.support@evicore, or reach us by phone at 800-646-0418, option 2.

Contra Costa Health Plan offers managed care to Medi-Cal beneficiaries in Contra Costa County.

Prior Authorization For Medical Services Contracting and non-contracting providers can contact Utilization Management at 1-877-208-4959 to request to obtain prompt authorization. View CCHP's policy on Prior Authorization on Medical Services.

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Subrogation Form In Medical Billing In Contra Costa