Providers - Provider Manual

Downloadable Provider Manual (PDF)

 

0. Table of Contents

1. Introduction - How to Contact Us

2. Verifying Member Eligibility

3. Products and Benefits

4. CCHP Provider Network

5. Referral and Authorization Process

6. Mental Health Parity

7. Utilization Management Program

8. Pharmacy Information

9. Claims Procedures

10. Access and Appointment Standards

11. About HEDIS

12. Quality Improvement Program

13. Member Appeals and Grievances

14. Language Assistance Services

15. Advance Directives

16. Member Rights and Responsibilities

17. HIPAA Protected Health Information

18. Fraud, Waste and Abuse

19. Medicare Risk Adjustment

Find our Physicians and Hospitals

Member Services
1-888-775-7888 (toll free)
1-415-834-2118 (local)
1-877-681-8898 (TTY)

Call 7 days a week
from 8:00 a.m to 8:00 p.m

Or, Visit
827 Pacific Avenue
San Francisco, CA 94133

M-F 8:30 a.m. to 5:00 p.m.
Sat. 9:00 a.m. to 5:00 p.m.
Closed on Sundays

Language Assistance
1-415-834-2118
1-877-681-8898 (TTY)

24/7 Nurse Advice Line
1-888-243-8310
24 hours a day / 7 days a week

Sales Representative
1-415-955-8800 ext.3256
 

STAGE TO CCHPHMO LIVE APRIL 20, 2013