Claims

Claims Submission 

Thank you for taking care of Community Health Group members. To ensure timely processing and payment of claims, we encourage you to submit claims via EDI using one of the clearinghouses below. Both contracted and non-contracted providers may submit claims to Community Health Group via EDI.


Alternatively, if you are a non-contracted provider, you may mail your claims to the following address:

Medi-Cal Claims:                                                                    Medicare Claims:

Community Health Group                                                  Community Health Group

PO Box 210100                                                                       PO Box 210157

Chula Vista, CA 91921                                                          Chula Vista, CA 91921

 

If you are submitting claims to Community Health Group for the first time, please make sure to attach your W-9 form and NPI to avoid delays in the processing of claims and correspondence. You may send this via email at providerenrollment@chgsd.com, fax at (619)382-1214, or mail out to:

Community Health Group

Attn: Provider Enrollment

2420 Fenton St., Suite 100

Chula Vista, CA 91914

Clean Claims Requirement

ICF-DD Clean Claim Instructions and Sample Claim

Non-Contracted Provider Accepted Codes and Reimbursement

The links below contain codes that are considered covered benefits for the Medi-Cal product line. This information is provided by the California Department of Health Care Services (DHCS) as information only for provider reference. CHG will reimburse non-contracted providers at the Medi-Cal rates and apply Medi-Cal guidelines for claims processing.

Medi-Cal Rates and Codes

DHCS Medi-Cal Provider Manual

Checking Claim Status

All contracted providers have access to the CHG Provider Portal and must check the claim status online. Non-contracted providers may email ooaprov@chgsd.com requesting claim status.

Our Provider Services Specialists are available at 619-240-8933 or ooaprov@chgsd.com to assist with any additional Claims questions.