Requirements for Hospital or Surgery Center Participation

1. Accredited by respective accrediting/certifying body (JCAHO, AAAHC, CARF, etc.)
2. Have a valid, current, unrestricted license in the state(s) in which the hospital will be providing care for CHA members
3. Facility is Medicare/Medicaid Certified
4. Carry adequate professional liability coverage in the amount which is required by state law to qualify as a hospital or Surgery Center under the Indiana Medical Malpractice act or Michigan State requirements
5. Current W9 Form

Hospitals and Surgery Centers must complete a Facility Profile.

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.