CHA Provider Manual
I. PPO - Select Circle  (PDF)
- Authorization Procedures
- Provider Directory
- Contracted TPA's
- ID Card
- Fee Policy
- CHA Contact List
II. HMO - Part 1 (PDF)
- Authorization Form and Procedures
- Referral/Plan Authorization Form
- Referrals for Gynecological Services
- Behavioral Health UM Program Evals
- Referrals for Obstetric Services
- Provider Directory
- Ambulatory Facilities, Ancillary Services, Clinics, Hospitals, and Pharmacies
II. HMO - Part 2 (PDF)
- Claim Submission
- Requirements
- Provider Inquiry Form
- Physician Availability
- Practice Guidelines
- Preventative Care Standards
- Adult Diabetic Patient Check off Sheet
III. Mplan ID Card (PDF)
III. Advantage ID Card (PDF)
IV. ASO (PDF)
- Authorization Form
- Policies and Procedures
- Schedule of Benefits
- Contact List
V. Behavioral Health (PDF)
- Table of Contents
- Authorization Policies and Procedures
- Forms
|
