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All the forms you need to submit are available as a free download, or you can submit your bills and forms online via the Member Portal. These forms are the Needs Processing Form (both sides), the Medical Release Form, the Letter of Explanation and the Prayer Page Request Form (the last form should be sent to CHM only if the treatment was for a pre-existing condition). Alternately, you can call the Needs Processing department at 1-800-791-6225 and ask that forms be sent to you by mail. It’s important that each form is filled out and submitted promptly to the address listed on the top of each form; missing forms will result in a delay in sharing your bills.
Do this even if a discount is still pending. The sooner CHM receives the bill, the sooner the bill can be shared and the faster you can pay your medical providers. You can always let CHM know about a discount later when it has been approved by your doctor or hospital. For bills to be eligible for sharing, CHM must receive bills within six months of the date of service.
For members with Medicare only, you can submit your Medicare Explanation of Benefits (EOB) instead of itemized medical bills. Please note that you’ll still need to submit the CHM Needs Processing Forms along with your EOB.
If obtaining itemized bills is a challenge, CHM can instead accept a CMS-1450 or UB-04 from your hospital or a CMS-1500 (formerly HCFA-1500) from your doctor—these are standardized billing forms used by health care providers. If your provider seems puzzled by what information, exactly, CHM needs to process your medical bills, please tell them that these standardized forms contain the exact information we need. If you still need help getting an itemized bill, contact CHM at 1-800-791-6225.
Notify CHM if your provider sets a time limit for reduced charges and the CHM staff will work with your provider to share the bill(s) on time. In general, bills are shared in the order they’re received at the CHM office. Also, the larger the discount given by providers, the faster bills often can be shared.
Treat as reimbursement from CHM (since you will be reimbursed) any portion of the funds you have already paid to your provider(s).
Sometimes called a “Stork Package” or “global fee" these rates often include all pre-natal and delivery charges at a reduced price. (When asking for a hospital prepayment agreement, keep in mind that room and board charges are not always included in the quoted price.) When you have it, submit the agreement to the CHM office and send any additional bills as “add-ons” to the original amount. In most cases, submitting a timely agreement enables CHM to share your maternity bills by the time the baby is born.