Coding Tips and Billing Reminders
CHPW Fall 2024 coding tips and billing reminders for providers.
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Provider Appeal Submission Methods
You can submit appeals to CHPW using the three methods
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Cyber Security Incident
CHPW will revert to its standard processes starting Monday, August 5th.
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New & Improved Care Management Program
CHPW’s newly improved Care Management program better supports Medicare members
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Practitioner Rights During Credentialing Process
Practitioner rights to review information, correct erroneous information, and obtain application status.
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New Option for Electronic Funds Transfers (EFT)
New avenue to request more secure changes to your existing EFT account or to sign up for EFT
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Provider Newsletter
Our latest Provider Newsletter highlights provider and staff training and the new provider directory.
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Scammers impersonating state regulators
Scammers are targeting health care practitioners in Washington state
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Secondary Option for Claims Submissions
CHPW is offering a secondary option for electronic claims submissions
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2024 Formulary Changes
Our Medicare formularies are updated monthly
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Health & Housing Toolkit
Resource for community partners who are working to advance health and housing partnerships
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Payment for OTP Services
Medicare is the primary payer for dual-eligible beneficiaries who receive Opioid Treatment Programs services
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CMS PDGM Payment Methodology
Since January 1, 2020, CMS has used PDGM to reimburse home health agencies that provide home health services.
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CMS SNF Payment Model
Read about CMS’s Patient-Driven Payment Model (PDPM), for reimbursing Skilled Nursing Facilities (SNF) stays.
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Medical Records for Post Payment Review
Providers need to provide complete and accurate records timely for post payment review
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Determining New or Established Patients
How to use evaluation and management (E/M) codes for “new patients” vs. “established patients”.
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CAHPS Survey for New Members
New members are receiving Consumer Assessment of Healthcare Providers and Systems survey soon.
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Procedure Code Lookup Tool
Our new prior authorization code lookup tool is coming soon, learn more.
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Pharmacy Preferred Newsletter
Our November 2021 Pharmacy Preferred Newsletter is now available.
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Billing and Rendering Taxonomy Requirements
CHPW’s clearinghouse has been rejecting any claims submitted without valid billing and/or rendering taxonomy codes and those claims are not submitted to CHPW.
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- TALK TO A SPECIALIST
- Click here to schedule a plan review with a Medicare enrollment specialist.
- NURSE ADVICE LINE
- 1-866-418-2920
- (TTY:711)
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- (TTY:711)
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Community Health Plan of Washington is an HMO plan with a Medicare contract and a contract with the Washington State Medicaid program. Enrollment in Community Health Plan of Washington depends on contract renewal. Community Health Plan of Washington complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. If you need an accommodation, or require documents in another format or language, please call 1-800-942-0247 (711) 8 a.m. to 8 p.m., 7 days a week. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-942-0247 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-800-942-0247 (711).
Based on a Model of Care review, Community Health Plan of Washington has been approved by the National Committee for Quality Assurance (NCQA) to operate a Special Needs Plan (D-SNP) through 2025.
Limitations, copayments, and restrictions may apply.
You must continue to pay your Medicare Part B premium.
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Language assistance services, including interpreters and translation of printed materials, are available free of charge.
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