Policies and Procedures

The following CHRISTUS claim policies are to assist providers when submitting claims and to provide information on how CHRISTUS processes claims for the service in reference. Policies are subject to change and will be updated to reflect any changes made. These policies do not guarantee payment of a claim.

• Accessibility of Network
• Annual Attestations from FDRs
• Annual Compliance Program Effectiveness Assessment - Medicare Advantage
• Mental Health Care and Physical Health Care Coordination
• Claims Processing Submission Guidelines
• Out of Network (OON) Prior Authorization
• Code of Ethics
• Communications Regarding Regulatory Changes
• Compliance Training and Education
• Coverage Determination Oversight and Monitoring
• Emergency Medical and Urgently Needed Services Claims
• Follow-up after Hospitalization for Mental Health Services
• Fraud, Waste, and Abuse
• Member Education and Self-Referral for Mental Health Services
• Member Privacy Rights
• Member Rights and Responsibilities
• Monitoring and Auditing
• Network Provider Education
• Non-Contract Provider Appeal
• Non-Discrimination Notice
• Non-Retaliation Policy
• Provider Complaints and Appeals
• Preventative Colorectal Cancer Screening with Additional Services
• Quality - Patient Safety Indicator Evaluation
• Reimbursement Policy - Routine Venipuncture and/or Collection of Specimens
• Transition Supply Process Oversight and Monitoring
• Transplant Policy

Last Updated Date: 6/8/26