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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.
Customer Service telephone operations are from AM to PM on weekdays, and from AM to PM on Saturday – (925) 676-7500.
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.
1-877-661-6230.
Please email Contra Costa County Communications Director Kristi Jourdan at Kristi.Jourdan@contracostatv or call 925-313-1180 if you need assistance finding the right department or person.
To change your CCHP Primary Care Provider (PCP), you can: Fill out and submit the online form below OR. Print, fill out, and fax or mail this pdf form to CCHP OR. Call Member Services at 1-877-661-6230 (Option 2) (TTY 711), Monday - Friday, 8am - 5pm.
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.
Contact Contra Costa Health Medi-Cal. If you have Medi-Cal questions, please visit Contra Costa Employment & Human Services (EHSD) or call 1-866-663-3225. Environmental Health. Use the Environmental Health Complaints page for restaurant, industrial or similar complaints. Health Plan. Telephone. Email/Online Form.
Contra Costa Health Plan (CCHP) follows all applicable Federal and State laws in the use of Telemedicine services to provide consultation, access and quality of care to our Medi-Cal and Commercial members.
Payer Name: Health First Health Plans.