As a Community Health Plan of Washington (CHPW) provider, you can count on our support in caring for your patients. Find answers to questions you may have about our provider portals, accessing training and orientation materials, and more.
How can I become a Community Health Plan of Washington Provider?
How can I receive technical case management assistance?
Case managers are available to provide technical assistance to PCPs and Specialists for members with any condition. This support includes arranging referrals including mental health, SUD, Long Term Support Services and community support services. To access these services, contact the Case Management team at 1-866-418-7004.
How do I register for the HealthMAPS portal?
Register for HealthMAPS here. You need your Billing Tax ID number(s) to register. It may take up to 10 calendar days for your registration to process. You will receive an email when your registration is complete.
How do I know if a drug I prescribe is on the formulary?
You can review the formulary lists to identify what drugs are covered by CHPW and which require preauthorization. Drugs not listed on our formulary require prior authorization. You can submit prior authorization requests through our care management portal (Jiva.)
For self-administered drugs requiring prior authorization, please contact Express Scripts at 1-844-605-8168 or use https://www.CoverMyMeds.com to start the prior authorization process.
Who do I contact for claim status, prior authorization, member benefits, or member eligibility?
Providers can get in touch with their Provider Relations Representative or contact customer service for assistance at 1-800-440-1561.
I have a patient who missed their appointment without warning. Can I still bill them?
No. Patients cannot be billed for missed appointments. Make sure they are aware of your clinic’s cancellation or late appointment courtesy policies.
My patient needs to see an out-of-network specialist. Can I still refer them?
You may refer your patient to a non-networked provider without submitting a prior authorization request.
If you still have questions, call Customer Service for help. Our representatives are available at 1-800-440-1561 (TTY Relay: Dial 711) Monday through Friday, from 8 a.m. to 5 p.m.