CHA Claim Status Form Email Form Claim Status Request Form Please use this secure form to request claim status, or use one of these additional options: Email: claimstatus@cha.faith Fax: 888-977-8826 Your Name * Your Email * Provider Name * Member Name * Member ID #: * Member DOB: * Date of service: * Billed amount * Select the CHA coverage type for this member * Primary Secondary Comments Captcha Submit Clear If you are human, leave this field blank.