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Created Date: 7/15/2019 11:39:23 AM Our goal is to provide you with the best care possible. Visit Benefits of Community Health Plan of Washington care Our three enhanced plans offer different services and benefits to fit your life. To request prior authorization, please submit y our request online, or by phone. Washington Apple Health IMC Behavioral Health Prior Authorization Request Radiology Prior Authorization and Notification Program The radiology prior authorization and notification programs support the consistent use of evidence-based, professional guidelines for diagnostic imaging procedures. Prior authorization is advanced approval of specific procedures, services, medical devices, supplies, and medications by CHPW. Drugs and DME require separate prior authorization. Jakafi (Washington) Prior Authorization Form - Community Plan. This list contains prior authorization requirements for care providers who participate with UnitedHealthcare Community Plan in Washington for inpatient and outpatient services. 2019 Benefits At-A-Glance . Kisqali (Washington) Prior Authorization Form - Community Plan. At Amerigroup Washington, Inc., we value you as a provider in our network. FFS= services covered with your Medicaid Services Card through Washington Apple Health Medicaid . Managed-care plans will continue to use their own preferred drug lists for drugs not included in the Apple Health PDL. It offers all the care you need, as well as many extra benefits that go beyond Apple Health alone. NOTE: If you have an Apple Health managed care plan, such as Amerigroup, Community Health Plan of Washington United Healthcare Community Plan, … That's why we’ve redesigned the provider site to make it more useful for you and easier to use. All covered services must be medically necessary and are subject to prior authorization requirements. Washington Apple Health IMC = HCA Provider . Covered services include: n Skilled nursing. The Washington Apple Health Medicaid Handbook for members of Coordinated Care tells you how our program works and what we offer. View online or download now. Home health care Prior authorization is required. Last Published 01.29.2019. Last Published 06.04.2019. Washington Apple Health IMC & Behavioral Health Services Only = HCA Provider Billing . Care Provider Manual. Prior authorization means your provider has to check with us to make sure we will cover a treatment, drug, or piece of equipment. If you are uncertain that prior authorization is needed, please submit a request for an accurate response. Psychological Testing Request for Authorization. Rev.0716 Medication Prior Authorization Request Form Coordinated Care, Washington *** Do Not Use This Form for Biopharmaceutical Products *** CoverMyMeds is Coordinated Care’s preferred way to receive prior authorization requests. Prior authorization is not required for: n Diagnostic and screening tests. Forms. Guidelines Manual and/or Fee Schedule Medicare Advantage = National Coverage . services through Washington Apple Health non- Have your provider fax your request and supporting paperwork to the Health Care Authority at 1-866-668-1214. You or your provider may call us and request a free copy of the decision-making criteria for services. Outpatient Washington Prior Authorization Form. To see what drugs are preferred and whether they need a prior authorization (PA), please go to the Apple Health Single PDL website. How CHPW Determines Prior Authorization. Washington Apple Health IMC Intake Request Fax Form (updated 9/2019) Washington Electronic Submission Form - commercial providers only. And some services need prior authorization. Washington Apple Health (Medicaid) is Washington's managed care Medicaid program, providing comprehensive medical benefits to adults, families, people with disabilities, children under 19, and pregnant women who meet income requirements. As a leader in integrated managed health care services for the public sector, Amerigroup Washington, Inc. helps adults, low-income families, children, pregnant women, those with disabilities and special needs plans get the health care they need.

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