CHW Claims
Essential guides and tools for CHW training, documentation, and Pear Suite billing—supporting compliance, accurate claims, and efficient service delivery.
Training & Resources
Access a centralized set of tools designed to support Community Health Workers and subcontractors in delivering compliant, efficient, and high-quality services. These resources provide clear guidance on Pear Suite billing requirements, CHW and peer training programs, documentation standards, claim configuration and submission, claim tracking, and requests for additional billable units—helping your organization stay compliant, organized, and audit-ready from onboarding to reimbursement.
Getting Started.
Managing Claims.
How to Fix or Re-Generate a Bill.
Requesting Additional Units Form.
Flag Compliance Review
In Pear Suite, "Flag for Compliance Review" generally means that the encounter, activity, documentation, or billing record has been marked for additional review before it can be finalized or billed.
Common reasons a case may be flagged include:
Missing required documentation
Incomplete case notes
Service time does not match the billed units
Missing consent forms or eligibility documents
Duplicate services entered on the same date
Services that do not meet payer requirements
Notes that are too brief or do not justify the service provided
Missing signatures or attestations
Data inconsistencies (for example, member information does not match the service record)
Claims & Documentation Training
Yash Patel met with the MNH team to review claims resolution, timely filing, and documentation best practices—covering common claim errors, eligibility checks, resubmissions, and the process for requesting additional units, with an emphasis on detailed, non-templated notes to avoid audit issues.
Claims resolution, timely filing, and documentation
Key issues addressed included correcting Kaiser CIN errors, regenerating "no billable activity found" claims, reissuing claims denied due to payer discrepancies, and understanding eligibility check details. Yash Patel outlined the process for submitting authorization requests for additional units beyond the initial 12 units and emphasized the importance of detailed notes and avoiding templates for documentation to prevent audit issues.
My New House Platforms.
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Hipaatizer
DIGITAL FORMS DESIGNER
Hipaatizer is a HIPAA-compliant online platform that enables healthcare providers and related professionals to create, manage, and embed secure digital forms and documents without coding. It offers a drag-and-drop form builder, conversion of existing PDF/Word forms into HIPAA-compliant formats, two-factor authentication, encrypted data storage, e-signatures, and integration options with EMRs/CRMs—helping organizations safely collect and transmit protected health information (PHI) while maintaining regulatory compliance -
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Casebook
CASE DOCUMENTATION
Casebook Case Management is a configurable, HIPAA-compliant human services software platform that helps organizations centralize and streamline client care, case tracking, documentation, collaboration, and reporting in one secure system. It supports nonprofits, social service providers, and public agencies with intake, case notes, analytics, workflow automation, and custom reporting—enabling teams to manage data, monitor outcomes, and improve service delivery from any device. -
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Pear Suite
BILLING & CLAIMS
Pear Suite is designed to empower Community Health Workers (CHWs), community-based organizations, and health plans with tools for care navigation, documentation, claims management, and billing reimbursement—all in one system. It supports care coordination, client communication, workflows, data tracking, and reporting, while enabling teams to address social determinants of health and unlock sustainable funding for community-centered services. -
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Los Angeles Housing Department
AFFORDABLE HOUSING SEARCH
Affordable & Accessible Housing Search (City of Los Angeles) is the online registry provided by the Los Angeles Housing Department (LAHD) that lets residents and housing advocates search for affordable and accessible rental housing units throughout the city, view available properties, and access related information such as pre-applications, grievance procedures, and rent limits. It’s a free tool for renters to find homes that meet accessibility needs and for property owners to list qualifying units.
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Los Angeles County Department of Consumer and Business Affairs (DCBA)
MEDIATION
LA County DCBA Connect Portal is an online service platform of the Los Angeles County Department of Consumer and Business Affairs (DCBA) that lets residents register or sign in to access consumer and worker support services such as filing complaints, requesting mediation, accessing the rent registry, foreclosure prevention, and reporting issues like price gouging. It provides a centralized dashboard to submit service requests and connect with DCBA resources and assistance.
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California Department of Health Care Services (DHCS)
MEDICAL SEARCH
Health Care Options Online is the California Department of Health Care Services (DHCS) portal that helps Medi-Cal beneficiaries explore and manage their managed care coverage. It lets users review health plan choices in their county, compare benefits, enroll or change plans, find providers, and access consumer-focused information and resources for Medi-Cal managed care programs.
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Accuity
SCHEDULING
Acuity (Acuity Scheduling) is a cloud-based appointment scheduling and booking platform that helps service providers automate client scheduling, calendar management, reminders, intake forms, and payments. It allows clients to view real-time availability, self-schedule appointments online, sync with calendars, and receive automated notifications—streamlining booking workflows for businesses, professionals, and health-related services.
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NordVPN
INTERNET SECURITY
NordVPN is a virtual private network (VPN) service that secures your internet connection by encrypting data and masking your IP address, protecting your privacy and online activity on any network. It helps users bypass geo-restrictions, prevent tracking, and enhance security on public Wi-Fi, making it useful for personal, travel, and remote work internet protection.
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SquareSpace
WEBSITE DESIGN
Squarespace is an all-in-one website building and hosting platform that enables individuals and businesses to create professional websites, portfolios, online stores, and blogs using customizable templates, drag-and-drop design tools, and built-in SEO, analytics, and e-commerce features—without requiring coding skills.
