- Browse 2018 Tier One Formulary
- Browse 2018 Tier Five Formulary
- Formulary Exception / Medicare Part D Coverage Determination Request Form
- Drug Recall Report
Payment Dispute Information
- Appeal and Payment Dispute Rights
- Payment Guide for Out of Network Payments
- Waiver of Liability Statement
All of our providers need to be compliant with state and federal regulations. To find resources about Fraud, Waste, and Abuse, and Ownership and Control Disclosure, please visit http://chpw.org/for-providers/documents-and-tools/.
Special Needs Plan: Transition of Care
Community Health Plan of Washington is committed to managing the transition of all SNP members from one care setting to the next, and back to their medical homes. This process will necessitate activities for us and the attending care taker(s) at each service facility. Please review and familiarize yourself with the following minimal expectations required to be completed whenever there is an SNP member planned or unplanned inpatient or discharge event.
They include but are not limited to:
- A discharge summary
- Medication list review with the member
- Review of any required follow-on appointments
For more information, see the Population Management at Community Health Plan of Washington Medicare Advantage Special Needs Plan Model of Care 2015.
If you have questions regarding Community HealthFirst Medicare Advantage Plans or Policies, please contact your Community Health Plan Provider Relations Representative.