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Our Responsibilities as Your Health Plan:
Give you information about the plan, its network of providers, and your covered services. We must provide information in a way that works for you (in languages other than English, Braille, large print or other alternative formats).
An appeal is a formal way of asking us to review and change a coverage decision we have made.
For prior authorizations for certain services, your Provider must contact us by telephone, electronically or in writing to request appropriate authorization.
Use these forms when you pay full price for a something you believe should have been covered by your plan. Complete the Part C Form for medical (doctor’s office) expenses and the Part D Form for pharmacy expenses.
Mail to:
Claims Payment Request
O. Box 301404
Houston, TX 77230-1404
Mail to:
Manual Claims
P.O. Box 1039
Appleton, WI 54912-1039
To appoint a representative to act on your behalf, you may download this form or call Member Services for assistance.
H9826_IT_10045_092919_M Last updated August 18, 2020.
As a local nonprofit health plan, Community Health Choice gives you plenty of reasons to join our Community. From the benefits and special programs we offer to the way our Member Services team helps you make the most of them, Community is always working life forward for you and your family.
“I always tell people to choose Community Health Choice. I tell them it’s the best health insurance they will ever be with.”– Chandolyn
Member of Community Health Choice
Copyright 2023 Community Health Choice. All Rights Reserved.