We’re here to make the billing process easy.
At Community Health Plan of Washington (CHPW), we aim to make it easy for you to find the billing information you need. Use the resources on this page to manage your practice’s billing, or see our Provider Manual for more information.
Balance Billing Training
We recommend newly contracted providers complete balance billing training within 90 days of their contract effective date.
After completing the training you must also complete an attestation.
New and Updated Billing Guidelines
CHPW billing guidelines may change over time. Below is the most recent guidance in alphabetical order.
*Click to see billing guidelinesAcupuncture Services — Apple Health (Medicaid)
We are excited to announce a new acupuncture benefit available to our adult Apple Health Members, ages 18 and older. Eligible members can receive up to 6 acupuncture visits from January 1 through December 31. Unused acupuncture visits do not roll over to the next calendar year.
CHPW would like to remind all clinics and providers that claims must be billed with valid, appropriate taxonomy codes for the billing provider and, when applicable, the rendering provider.
Effective January 1, 2021, CHPW’s clearinghouse will reject any claims submitted without valid billing and/or rendering taxonomy codes and those claims will not be submitted to CHPW.
Community Health Plan of Washington (CHPW) is excited to announce a new value-added benefit for CHPW Apple Health members: For services starting February 1, 2021, CHPW will pay up to $200.00 for non-medically necessary circumcision.
We’ve updated our Core Provider Agreement information. Please see our Core Provider Agreement for Medicaid Services FAQs.
Updates have been released from the Health Care Authority (HCA) related to billing codes related to behavior health services. Review these in consideration for your behavioral health services.
As of December 1, 2018, NTT Data processes HIPAA 270/271 (Eligibility/Benefit Inquiry and Response) and 276/277 (Claim Status Inquiry and Response) transactions.
Learn how to view prior authorizations and referrals, as well enter claims in our HealthMAPS patient information portal.
Download the below forms as PDFs and follow the instructions to manage your practice’s claims with CHPW.
- Claims Supporting Documentation Cover Sheet
- Corrected Claim – Standard Cover Sheet
- Hysterectomy Consent Form
- Sterilization Consent Form
- Sterilization Consent Form – Spanish
- 1500 Claim Form and Instructions
- UB04 Claim Form and Instructions
Electronic Funds Transfer (EFT)
Receive your payments faster by signing up for Electronic Funds Transfer (EFT). CHPW can issue EFTs to all healthcare provider types, including those receiving capitation.
Email our Provider Relations Team with questions about billing. One of our Provider Relations Representatives will contact you.