Clinical Trail PA Requirements and Request Form - Washington State Local Health Insurance - CHPW
Community Health Plan of Washington Apple Health Medicaid Plan Community Health Plan of Washington Apple Health Medicaid Plan

Clinical Trail PA Requirements and Request Form

CHPW requires Prior Authorization for Clinical Trials. CHPW has posted a Clinical Trial Prior Authorization Request Form on our website at https://www.chpw.org/provider-center/prior-authorization/.

This includes an attestation required for all Clinical Trials and should be used for any Prior Authorization request for a clinical trial on our website at https://www.chpw.org/wp-content/uploads/content/provider-center/prior-authorization/Clinical_Trial_Prior_Authorization_Form.pdf

Please send your questions to [email protected]

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