Provider Disputes

Contracted provider disputes are to be written to CCHCA and/or the member's applicable health plan, challenging, appealing or requesting reconsideration of a claim (or a bundled group of substantially similar multiple claims that are individually numbered). The links below contain necessary dispute resolution request form, and instructions on how to submit the request.

Provider Dispute Resolution Request Form

CCHCA Provider Dispute Resolution (Instructions)

Please complete a Provider Dispute Resolution Request and email to:

If you have any questions or would like to know more about the resolution process, please call (415)216-0088 option 3, and then option 2.