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For Providers

Bulletin Board

  • Change to ERA Enrollment Process
    The new enrollment process for 835/ERA transactions is all electronic and does not require a fee to register or enroll.
  • New Procedure Code Lookup Tool
    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.
  • HCA Interpreter Services
    The Health Care Authority is reaching out to provide information about how to use its interpreter services vendor, Universal Language Service.
  • Partnership Access Line for Moms
    Health care providers caring for patients with behavioral needs during pregnancy and postpartum can call PAL for Moms for consultation.
  • Provider Newsletter
    Read our latest Provider Newsletter! The Fall 2019 edition includes important information on our 2020 Medicare Advantage plans, our new Medicare name, a suicide care webinar, a conversation guide for vaccine hesitancy, and more.
  • Provider Portal Update
    Our old Health Information Portal (HIP) will no longer be available as of September 13, 2019. In addition, we’ve added a new feature to our HealthMAPS provider portal.
  • 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.
  • Primary Care Behavioral Health Billing Updates
    The Health Care Authority has released updates on billing codes related to behavioral health services.
  • Improving Physical Accessibility
    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.
  • People With Disabilities
    Did you know that health care providers are required to offer everyone access to medical services without discrimination on the basis of disability?
  • Valid NPI for MA Claims
    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.
  • Receive Your Payments Faster
    If you're still receiving your payments by check, consider enrolling in Electronic Funds Transfer. Your payment will be deposited in your checking account.
  • New Online Provider Directory
    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.
  • New Acupuncture Benefit
    We are excited to announce a new acupuncture benefit available to our adult Integrated Managed Care and Apple Health Members, ages 18 and older.
  • MyCHPW Member Portal
    Members have access to their own MyCHPW portal, where they can keep track of their coverage and health information.
  • Codes and Criteria
    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.
  • UPDATED: Provider Roster FAQ
    Please review your directory information and report any necessary changes to us.
  • UPDATED: Provider Directory Quality Assurance
    Updated information on how Community Health Plan of Washington is working to ensure the accuracy of our provider directory.
  • Core Provider Agreement Update
    We’ve updated our Core Provider Agreement information. Please see our Core Provider Agreement for Medicaid Services FAQ.
  • 2019 Provider Manual
    The 2019 Provider Manual is now available. This inclusive guide is your resource for CHPW procedures, forms, compliance, programs, and more.
  • UPDATED: 270/271 and 276/277 Transactions
    As of December 1, 2018, the service previously provided by Emdeon is no longer available.
  • Upcoming Training Sessions
    Providers always have access to CHPW's training documents, workbooks, and a calendar of upcoming training events.
  • Introducing HealthMAPS
    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.
  • HCA Change to Interpreter Services
    Effective July 1, 2018, the HCA has changed its contracted vendor for interpretive services.
  • Billing for Miscellaneous 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.
  • 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 Transactions Moving to NTT
    These transaction changes are effective March 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.
  • 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.
  • 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.
  • 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.