Payor Contract Requirements
Community Health Alliance

Payor Contract Requirements

  • Guarantee the CHA logo on all I.D. cards and EOB’s.
  • Guarantee a minimum of 20% benefit differential be implemented on all accounts.
  • Guarantee that payors will pay all clean claims within 30 days or the discount will not apply.
  • Provide quarterly reports on hospital usage to CHA by the 5th of the month following the end of each quarter.
  • Contract with CHA exclusively to ensure the best discount possible.
  • Provider account information to CHA on a monthly basis.
  • Pay an access fee to CHA per employee per month.
  • Guarantee there will be no dual network options offered to employers without CHA prior approval.
  • Notify CHA on who is repricing claims and conducting Utilization Review.

Disclaimer: This information is for informational purposes only and is not intended to constitute professional advice as circumstances may vary. CHA is not liable for information contained on this site. Fee schedule information applies only to M.D.s and D.O.s, not to any other Allied or Behavioral Health providers. CPT code allowables are global and do not represent modifiers. Information contained on this website is subject to change.