Community Health Network

Community Health Networks (CHN) is a unique partnership between employers and health care providers.

CHN is a local non-profit health care network created to serve the health care needs of employers and employees living and working in the Central Valley of California.

CHN brings employers and health care providers together to create access to affordable high quality healthcare services.

About

Closing Gaps in Care

Evidence-based clinical guidelines are scientifically derived guidelines for the diagnosis and treatment of certain specified medical conditions. Following these guidelines can lead to improved care and lower costs.

Controlling chronic conditions prevents them from accelerating to acute conditions, and acute conditions accelerating to catastrophic conditions.

Our care management program identifies gaps in care, noncompliance with treatment plans, individuals at risk for adverse medical  events, and drug interactions for the entire covered population.

As specific risks are identified, our Nurse Care  Managers work one-on-one with at-risk patients and their physician or physicians.

Health Utilization Management

To ensure you get the right care, at the right time, and in the right setting, our health utilization management services incorporate two leading edge programs: hospitalist services at CHN hospitals and URAC-accredited review of outpatient services.

Primary Care Services

You can select from any of the primary care physicians in the network to meet your and your family’s needs, whether it’s an Internist, Family or General Practitioner, Pediatrician or OB-GYN. The choice is yours … and you can change physicians at any time. No plan approval required.

Specialist, Hospital and Ancillary Care Services

Specialist, hospital, and ancillary care services are available through CHN network contracts with health care providers throughout the Central Valley and in major referral centers across the State of California.

Finding a Health Care Provider

Finding a health care provider is easy. You can search using Search Providers or Contact Us us at 1.855.537.6769.

Referral and Emergency Care

CHN members have access to over 500,000 other health care providers across the country. In the event of an emergency outside of the CHN service area or for care approved to be provided out of network by your plan, we have you covered!

Spending Your Health Care Dollar Wisely

Our health care provider contracts include highly competitive reimbursement rates for providers. This means your health care dollars go to work for you, locally, and in the best way possible.

Benefit Plan Design and Administration

Benefit plan design and your plan’s third party administrator are determined by your employer. Contact your benefits or human resource department for more information.

Provider Search

PDF Provider Directory
PDF Directorio de Proveedores

PDF Provider Directory – Mental Health
PDF Directorio de Proveedores- Salud Mental

Shoppable Codes and Directory Search – Advantek
Shoppable Codes and Directory Search– Healthcomp

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Provider Nomination

Welcome to The Community Health Networks

As a contracted network provider you get:

  • A dedicated provider relations team to keep you informed and provide support in person and by phone
  • Ability to check member eligibilityauthorization status, and claims status through our TPA partner’s online self-service tool, or by calling us at 1.855.537.6769..
  • Educational materials for your patients (e.g., information about our benefits and services) and displays for your office
  • Multilingual, multicultural customer service for your patients
  • A dedicated claims team to ensure you get prompt claims payment for electronic and paper claims
Provider Nomination

Providing you with the best network with the best health care providers is our goal.  If you have a provider that you would like us to consider adding to the Community Health Network, please let us know! 

You can email our Provider Contracting Department  or call us at 1.855.537.6769.  Be sure to include the following:

  • Your contact information in case  we need any clarifications or additional information.
    • Your Full Name
    • Your phone
    • The best time to contact you
  • Provider’s Practice or Group Name
  • Full Provider’s Name
  • Provider’s Specialty
  • Providers Address
  • Providers Phone

If you are an existing provider, updated demographic information will allow HPNC to provide our members and other contracted providers accurate information listed in the provider directory.  Additionally, demographic information is used in the claim processing process and up to date provider information. Accurate information will assure that claims gets processed in a timely manner. Please complete the Provider Information Form and return to Provider Relations team via email.

Contact

Member Questions
Provider nomination questions1.855.537.6769
Current enrollment questions1.855.537.6769
Claim status questions1.855.537.6769
Pharmacy questions 
Provider Questions
Questions on how to contract1.855.537.6769
Questions on claims status1.855.537.6769
Questions on pre-certifications1.855.537.6769