Welcome to the Claims Guidelines Page
- Claims Processing by CBHA
- CBHA processes claims for services rendered by behavioral health providers for behavioral health diagnoses.
-
Claims for services rendered by medical providers are processed by the medical claims administrator of the plan.
-
Timely Submission – CBHA network Providers must submit clean claims within 365 days of service. Providers are advised to file in a timely manner.
-
Appeals – Written appeals are sent to us with 365 days of the date of service. Please include reason for appeal.
-
COB Claims – If another insurance is primary to the plan benefit processed by CBHA, file the primary insurance first. Attach the payment or denial remittance statement from the primary insurance to the claim, then file to CBHA. CBHA will extend the timely filing limit beyond 365 days from date of service for co-ordination of benefit claims, but not longer than 60 days from the date on the primary remittance. In no event will the limit be extended beyond 18 months.
