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For Providers

Bulletin Board

  • Upcoming Training Sessions (Buprenorphine Waiver)
    The Washington Department of Health is sponsoring a series of training sessions that will allow physicians to prescribe buprenorphine for office-based treatment of opioid use disorder.
  • HCA Change to Interpreter Services
    Effective July 1, 2018, the HCA has changed its contracted vendor for interpretive services.
  • New Provider Portal Coming this Fall
    Launching this fall, our new Health Member and Provider Services portal (HealthMAPS) will be an upgrade and replacement for the current Health Information Portal, or HIP.
  • Billing for Micellaneous Parts
    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.
  • Provider Newsletter
    Read our latest Provider Newsletter! The Summer edition contains information about 90 day fills, Single Preferred Drug List, Medicare, billing guidelines, and more.
  • Medicare Diabetes Prevention Program
    As of April 1, 2018, Medicare now reimburses registered providers for the Medicare Diabetes Prevention Program (MDPP).
  • Medicare Crossover
    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.
  • Billing Requirements for Diagnosis Code Limits
    There are new billing requirements for diagnosis code limits.
  • Service Location (Box 32) Guidelines
    Just a reminder about our policy regarding the service location on claims forms.
  • EBP Codes for IMC, Behavioral Health Providers
    Providers of children’s mental health services must include evidence based practice (EBP) codes when submitting claims beginning April 1, 2018.
  • New Legislation on Children’s Mental Health Care Access
    If you are a Primary Care Provider, a Pediatrician, or a Mental Health Care Provider, please be aware of new legislation and expectations for you.
  • New Clinical Practice Guidelines
    CHPW has added several new guidelines this year.
  • New Transactions Moving to NTT
    These transaction changes are effective Marc 1, 2018.
  • Collaborative Care Codes
    On January 1, 2018, new billing codes were released around the Psychiatry Collaborative Care Model (CoCM) for Medicaid and Medicare.
  • New Behavioral Health Integration Codes
    There are a number of new advances in payment to support integration of behavioral health services into medical settings.
  • Billing for Administration of Drugs
    Clarification on the guidelines for billing of the administration of drugs when the drug was not supplied by the administering provider.
  • Transportation Coverage
    Transportation services are now considered for payment via Fee for Service by the HCA.
  • Transactions Processing Transition
    We are holding a test phase for upcoming transition of HIPAA 270/271 and HIPAA 276/277 transactions to NTT Data from January 15 to February 15. Please enroll now if interested.
  • WA Recovery Help Line
    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.
  • 2018 Health Benefit Exchange
    Community Health Plan of Washington will not participate in the Health Benefit Exchange in 2018.
  • Capitated Claims Enhancement for 835
    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.
  • Electronic Data Interface FAQ
    Community Health Plan of Washington supports specific electronic transactions. Learn how to submit electronic claims and more with these FAQs.
  • Mandatory Modifiers on Medicare Claims
    We'd like to remind you that Medicare claims submitted without the correct modifiers will be rejected and will have to be resubmitted. CHPW will have a new claim edit in place as of 9/18/2017.
  • New HCA Opioid Policy
    A new clinical policy pertaining to opioid prescriptions takes effect for Apple Health on Nov. 1, 2017
  • Telehealth Services
    More patients are interested in telemedicine. See rules and guidelines for this service from CMS and the HCA.
  • Standard Formulary in 2018
    Beginning in 2018, all Washington managed care organizations and fee-for-service will use a single formulary.
  • How to get ready for new Medicare cards
    CMS will begin replacing current Medicare cards with cards that are more secure. Here are five ways to get your office ready for the change.
  • HCA Changes to Interpreter Services
    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.
  • Medically Intensive Children’s Program (MICP)
    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.
  • Payment Calculation Update
    Community Health Plan of Washington (CHPW) is updating the grouper and weights used to calculate payments for Medicaid outpatient hospital services.
  • CDR Information
    Use our checklist to see if you are required to submit to the Clinical Data Repository.
  • DSC Editor Update
    We are updating our data sensitive code for Medicare inpatient services.
  • Billing Single Dose Vials
    Washington State Health Care Authority has updated the Billing for Single-Dose Vial guide with examples.
  • Pricing Methodology Resource
    If you would like to learn more about EAPG and APR-DRG pricing, please click through to our new resource or email cs.claimsdistribution@chpw.org.
  • Understanding Dosage-Based Assessment
    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.
  • Upgrade to Claims Editing System
    We have upgraded our claims system to ensure the most current coding, accuracy of processed claims, and more.
  • Requirement Clarification
    The Health Care Authority has released a statement clarifying the Electronic Health System requirements, Clinical Data Repository requirements, and fees.
  • Partnership Access Line (PAL)
    The telephone-based child mental health consultation system is available to connect your patient with mental health resources regardless of insurance.
  • Update to Timely Filing Terms
    We've updated our Provider Manual to clarify the Timely Filing Requirements for Medicare Advantage claims and Washington Apple Health claims.
  • Sports Physical Billing
    CHPW has added a new value-added benefit that covers annual sports physical exams for Apple Health kids age 6 -18 at no cost to the member.
  • Podiatry Benefit Change
    Effective immediately, specific Bunion procedures will no longer be included as covered benefits. Read more to find out which CPT codes will now be listed as non-covered.
  • Retroactive Enrollment
    Beginning April 1, 2016, the Health Care Authority will be implementing retroactive enrollment.