Frequently Asked Questions
Community Health Alliance

Frequently Asked Questions

Q: How do I check the status of my claim for medical benefits?

A: Look on your insurance card and find a phone number for the Payor/Insurance Carrier. Call that number during normal business hours and ask about the status of the claim in question.

Q: What types of questions will CHA be able to answer?

Caregiver and PatientA: CHA staff are available at 574-647-1820 or toll-free at 888-689-2242 to answer your questions regarding which provider is in network and which provider is not. When you call us we answer your question regarding the provider's participation. You can call the Payor/Insurance Carrier to ask questions about your coverage, benefits and eligibility.

Q: Is a certain doctor or facility in network?

A: Please visit our Provider Search to see if that doctor is in network or call our member services number at 574-647-1820 or toll-free at 888-689-2242. You can also verify with the provider at the time of service.

Q: The facility is listed as in network - why was the claim paid at an out-of-network benefit level?

A: Providers may act independently from the facilities; you will want to call CHA with the provider's name and location. You should check participation of all providers who will take part in your service. Other possibilities could include: providers may not be in network at all of their locations, or the provider is in process of being credentialed and not active at the time services were rendered. Refer specific questions to CHA at 574-647-1820 or 574-647-1820 or toll-free at 888-689-2242.

Q: How can I get my provider or facility in the CHA network?

A: Fill out our Provider Nomination Form and send it back to our Provider Relations Department. If your provider meets all of CHA's requirements, we will attempt to recruit your provider in network.

Q: Do I need to pre-certify my upcoming procedure?

A: Call the pre-certification number that is listed on your card. If there is no specific number for precertification, just call the number listed for the Payor/Insurance Carrier.

Q: Since my provider is in network, will the Durable Medical Equipment he/she provides be in network?

A:Not necessarily. The provider is able to get DME/Home Care from various suppliers. It is ultimately the member's responsibility to confirm the providers and supplier are in network. Please be sure to ask your provider to confirm that the supplier is in network with CHA. They too can call member services at 574-647-1820 or toll-free at 888-689-2242.

Q: Since my provider is in network, will the provider he/she refers me to be in network?

A: Not necessarily. It is ultimately the member's responsibility to confirm that providers are in network. Please be sure to ask your provider to confirm that the referred provider is in network with CHA. They too can call member services at 574-647-1820 or toll-free at 888-689-2242.

Q: How do I lower my out of pocket expenses?

A: To keep costs down, go to an in-network provider whenever possible. You can use an out-of-network provider, but keep in mind that your benefits could be limited and your out of pocket expenses may be greater. If your plan does not offer out-of-network benefits, you as the member, may be responsible for payment in full if you use an out-of-network provider.

Q: How does the provider's office know that I am a CHA member?

A: When you present your medical insurance ID card, CHA in-network providers will recognize the CHA logo. If you receive a new card from your insurance carrier, please make sure to discard of the old and always present the new card to the provider's office.

Q: What happens if the provider that I am searching for isn't listed?

A: You can try to search for the provider alphabetically or search under a related specialty in the CHA provider search area of our website. If you still cannot find your provider, you can call Member Services at 574-647-1820 or toll-free at 888-689-2242 to confirm that they are not in network with CHA.