Claims
We want to make it as easy as possible for you to conduct business with us. In addition to information about how to submit claims and check payments, CGHC offers you tools to find specific information, such as claim status and member coordination of benefits (COB) status.
CGHC accepts claims in a variety of formats, including online and paper.
Preferred Option: Submit Claims Online
Providers have the option to submit claims through our secure, online Provider Portal. You can submit claims, track claim payments and more. CGHC offers this service at no cost.
We encourage you to submit claims online to take advantage of the following benefits:
- Faster claim processing
- Reduced administrative costs
- Reduced probability of errors or missing information
- Faster feedback on claim status
- Minimal staff training or cost
Refer to the Provider Manual for detailed information to submit claims.
CGHC also partners with Availity to offer electronic claim submission and real-time transactions at no charge through the Availity Portal beginning January 1, 2025. You can use the Availity Portal Registration Guide.
Get Paid Electronically
CGHC has partnered with ECHO Health, Inc. to deliver provider payments. ECHO offers three payment options:
- Electronic Fund Transfer (EFT) – preferred
- Virtual Card Payment (QuicRemit) – Standard bank and card issuer fees apply*
- Paper Checks
*Payment processing fees are what you pay your bank and credit card processor for use of payment via credit card.
Enrollment Instructions
Enroll with ECHO for payment and choose EFT as your payment preference. Questions? Call ECHO Customer Support at 1-888-834-3511.
Alternative Option: Submit Paper Claims
For the most efficient processing of your claims, CGHC recommends you submit all claims electronically. Paper claims can also be uploaded via the Provider Portal. Refer to the Provider Manual for instructions to submit paper claims.
Non-Participating Providers
Non-participating providers may submit claims to CGHC using the Non-Participating Provider Profile Form (Coming Soon). CGHC is unable to process claims without this information. Please be sure to attach your W-9 form when you submit this online form.
Claim Overpayment Recovery Requests and Resources
Overpayment Recovery Form – Submit this form to offset overpaid claims against a future payment.
Providers may also submit overpayment recovery requests via the Provider Portal and receive a reference number.
High-Dollar Claims
Submit this Itemized Bill Cover Sheet and itemized statement for high dollar claims.