Stay informed on important policies
On this page, you’ll find the written policies pertaining to many important Community Health Plan of Washington (CHPW) services. For more information on these policies, you can also browse your CHPW Provider Manual.
Please contact us with any questions. Our goal is to be transparent and thorough, so that you and our members are set up for success.
- Administrative Days Policy (MM156)
- Advance Directives and Physician Orders for Life Sustaining Treatment (POLST) Policy (CM118)
- Authorization and Certification (UM203)
- Benefit Coverage Exceptions to Rule Policy (UM427)
- Discussing a Denial (Adverse Benefit Determination) with a Reviewer Policy and Procedure (MM124)
- Emergency Fill Policy (PM516)
- Extension of Benefit Limitations (UM428)
- Extenuating Circumstances for Prior Authorization Policy (UM446)
- Honor Authorizations and Authorizations for Incarcerated Members (UM443)
- Hospital Admission Patient Management (UM211)
- Injectable Medications Policy (PM566)
- Obtaining Medicare or State Benefits During a Federal or State Disaster or Other Public Health Emergency Policy (UM231)
- Patient Review and Coordination Program Policy (CM521)
- Pharmaceutical Management Procedures Policy (PM508)
- Pharmaceutical Patient Safety Policy (PM509)
- Pharmacy Access During a Federal Disaster or Other Public Health Emergency Declaration Policy (PM514)
- Pricing Policy (OP647)
- Quantity Limits Policy (PM506)
- Step Therapy Policy (PM507)
- Transition Process Policy (PM515)
