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Public program for low income people
Medicare and Medi-Cal benefits
Medicare plan for chronic care needs
Resources for Providers
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.
For more information related to electronic claim submissions, please refer to
CHG’s EDI Companion Guide
Sender ID | Clearing House Name | Line Of Business | Payment Type | Payer ID | Claim Type | ERA |
---|---|---|---|---|---|---|
133052274 | Emdeon/Optum | All | Same for both | 66170 | Professional and Institutional | Yes |
263923727 | Gateway/Trizetto | All | Same for both | 95376 | Professional and Institutional | Yes |
263923727 | Gateway/Trizetto | All | Same for both | U5376 | Institutional | Yes |
581651222 | Optum (Formerly Change Health, Relay Health) | All | Same for both | 7110 | Professional | Yes |
581651222 | Optum (Formerly Change Health, Relay Health) | All | Same for both | 7668 | Institutional | Yes |
611358935 | Zirmed/Waystar | All | Same for both | Z1700 | Professional and Institutional | Yes |
330897513 | Office Ally | All | Capitated | 66171 | Professional | Yes |
330897513 | Office Ally | All | Fee For Service | 66170 | Professional and Institutional | Yes |
300001057 | Cortex EDI | Medi-Cal | Same for both | CX057 | Professional and Institutional | Yes |
300001057 | Cortex EDI | Medicare | Same for both | CX058 | Professional and Institutional | Yes |
432018849 | Med Assets EDI Service/FinThrive | All | Same for both | 95376 | Professional and Institutional | Yes |
800238572 | Turbo Tar | All | Same for both | 953766170 | Professional and Institutional | Yes |
ZOTEC | ZOTEC | All | Same for both | 953766170 | Professional | Yes |
Alternatively, if you are a non-contracted provider, you may mail your claims to the following address:
Medi-Cal Claims:
Community Health Group
PO Box 210100
Chula Vista, CA 91921
Medicare Claims:
Community Health Group
PO Box 210157
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
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.