Our April 2020 Pharmacy Preferred Newsletter is now available. It contains information on important COVID-19 updates, additions to the Single Preferred Drug List, and more.
Read our latest Provider Newsletter! The Spring 2020 edition includes information on COVID-19 policies, billing and resources; changes in payment for Opioid Treatment Programs; CHPW Medicare Advantage dental codes, and more.
Apple Health Dental Services Effective January 1, 2020
Prior to January 1, 2020, all dental services for Apple Health enrollees were billed to the HCA as fee-for-service. Effective January 1, 2020, some services will be billed to the enrollee’s managed care organization.
CHPW is launching a new Procedure Code Lookup Tool on November 1, 2019. You can search for services by procedure code and line of business to determine if a prior authorization (PA) is required, and much more.
New Add Change Term Forms for Individual Providers, Clinics, and Groups
CHPW’s new Clinic and Group Add Change Term online form is now available on our website. The forms are used to notify us of changes in your information.
This CMS document provides recommendations on how health care providers and facilities can improve accessibility in order to boost the quality of care for patients with disabilities.
CHPW will follow a new process to ensure the Medicare Advantage encounter data we submit to CMS include valid National Provider Identifier (NPI) numbers.
Involuntary Treatment Act Services for Dual Eligibles
Federal and state rules dictate how to provide and pay for crisis services and involuntary treatment associated with mental health and substance use disorder for Medicare/Medicaid clients.
If you're still receiving your payments by check, consider enrolling in Electronic Funds Transfer. Your payment will be deposited in your checking account.
CHPW has rolled out a new version of our online provider directory. The redesigned site offers more features and a more organized and easy-to-use experience.
Learn about how to obtain prior authorization, bill, and interpret the new CPT codes for psychological and neuropsychological assessments that went into effect in 2019.
HealthMAPS is CHPW's new provider portal and will replace the Health Information Portal (HIP). Read about some of the new features and learn how to create a HealthMAPS account.
For specific DME, CHPW must verify the actual manufacturer’s suggested retail price (MSRP) in order to provide pricing. Miscellaneous wheelchair parts (HCPC K0108) is one.
CHPW has entered into an agreement with Benefits Coordination & Recovery Center (BCRC) to electronically Crossover Part A and Part B claims from Medicare to CHPW beginning in June, 2018.
The WA Recovery Help Line, a service of Crisis Clinic, is a 24-hour crisis intervention and referral line for those struggling with issues related to mental health, substance abuse, and problem gambling.
Capitated claims will report the allowed amount in the X12 on the provider’s write-off amount and on the contractually allowed amount for the claim line.
More patients are interested in telemedicine. See rules and guidelines for this service from CMS and the HCA. Learn more at https://www.chpw.org/for-members/telehealth
The Health Care Authority (HCA) Interpreter Services Program is changing rates paid and reimbursed for language services provided to Apple Health clients. These changes take effect July 1, 2017.
The Medically Intensive Children’s Program (MICP) provides skilled nursing services to children ages 17 and younger. These children have complex medical needs that require a registered nurse to provide support.
Make sure you understand how to complete the Dosage-Based Assessment process and include it with your claims. DBA helps ensure children under the age of 19 can receive vaccinations regardless of insurance status.
