Forms

Children's Health Insurance Program (CHIP) Notice

Mother and Newborn Act

Women’s Health and Cancer Rights Act of 1998

Medical Claim Form

Authorization to Release Protected Health Information Form

Clean Claim Letter

Current Health Solutions - Prior Authorization Request Form

Current Health Solutions - EFT and ERA Set-Up Instructions

Web Portal Guide

Web Portal Flyer

Balance Billing Protection Notice

CHS Contact Information

Applied Behavior Analysis (ABA) Treatment Form

Code Edit Review Form

Outpatient Mental Health Continued Treatment Form

Add-on Code Edits Fact Sheet

Global Maternity Code Edits Fact Sheet

Global Procedure Code Edits Fact Sheet

Medically Unlikely Edits Fact Sheet

Multicode Rebundling Fact Sheet

Procedure-to-Procedure (Unbundling) Edits Fact Sheet

Web Portal Guide