Claims & Eligibility

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Billing for Preventive Services

The required guidelines for billing Preventive Services for Culinary participants and their eligible dependents can be found here.

Occurrence Process

The Culinary Health Fund strives to ensure quality healthcare and access for Culinary Health Fund participants. This goal is accomplished through our contracted PPO network of providers by ensuring that participants are referred within this network to minimize their out-of-pocket costs.

In support of this, the Fund has established a program that holds contracted PPO network providers financially accountable for referrals made to an out-of-network provider.

If a PPO provider refers a Culinary Health Fund patient to an out-of-network provider, this is considered an occurrence, and the provider will be held financially responsible in accordance with the Preferred Provider Agreement.

Common occurrences can include referrals to out-of-network cardiac monitoring providers, laboratories, DME providers, or any other non-PPO provider. For a complete listing of PPO providers, click here.