OHI and TPL - Washington State Local Health Insurance - CHPW
Community Health Plan of Washington Apple Health Medicaid Plan Community Health Plan of Washington Apple Health Medicaid Plan

OHI and TPL

Other health insurance (OHI) information in the state’s ProviderOne system may be inaccurate or out of date. CHPW collects, verifies, and then reports other health insurance for our members back to the Health Care Authority via a monthly update file.

There may be a window of time where member third party liability TPL/OHI information has changed in HealthMAPS but has not yet been reported to the HCA.

Please always consider HealthMAPS as the system of truth concerning our members’ other health insurance information. View capitation and member roster reports. Providers are in violation of State Code when they refuse to provide services to CHPW members based on TPL information in ProviderOne, HealthMaps and/or etc.

Delaying or stopping a member from receiving healthcare due to private insurance is addressed in WAC 182-501-0200 (9) as follows:

9) A Provider cannot refuse to furnish covered services to a client because of a third-party’s potential liability for the services.

For more information, please contact CHPW’s Customer Service at 1-800-440-1561.

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