Forms

Having important information that is used on a regular basis is important for busy HHP members.  This forms page is created to make finding the information you want quickly. 

Billing Codes

• HCPCS Hearing Codes V5000-V5999
• ICD-9 Codes
• ICD-9 Index
• ICD-9 Preface
• ICD-9 Appendix E-3-Digit Categories 001-E999
• ICD-9 Diseases of the Ear and Mastoid Process 380-389 (word)
• ICD-9 Diseases of the Ear and Mastoid Process 380-389 (pdf)

General Forms

• AHAA Member Request Form
• AHAA HHP Member Enrollment Form
• CAPS Forms
  • Review our dental or vision plan benefit and rate information.
  • Enroll in dental or vision plans.
  • Learn more about or request a quote for the medical insurance plan options.
• Ethics Complaint Form
• HHP Membership Application 
• Managed Care Application 
• PAC Donation Form
• Blue Cross of California Member Responsibility Agreement (word doc)
• Blue Cross of California Member Responsibility Agreement (pdf)
• A Sample of HHPCA Financial Policy (word doc)
• Hearing Healthcare Providers Fitting Protocol (word doc)
• Hearing Healthcare Providers Hearing Aid Dispensing Protocol (word doc)
• Hearing Healthcare Providers Code of Ethics (word doc)