Community Health Plan of Washington Medicare Advantage Plans Community Health Plan of Washington Medicare Advantage Plans

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Medicare Advantage Plan - Bulletin Board

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2023 Formulary Changes
2023 Formulary Changes

Our Medicare formularies are updated monthly and last approved date is 10/01/2023

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Health & Housing Toolkit
Health & Housing Toolkit

Resource for community partners who are working to advance health and housing partnerships

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Provider Newsletter
Provider Newsletter

Our latest Provider Newsletter highlights provider and staff training and the new provider directory.

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Payment for OTP Services
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
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
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
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
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
CAHPS Survey for New Members

New members are receiving Consumer Assessment of Healthcare Providers and Systems survey soon.

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Prior Authorization 2023 Changes
Prior Authorization 2023 Changes

2023 PA List and Utilization Guidelines (effective: Jan 1, 2023)

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Procedure Code Lookup Tool
Procedure Code Lookup Tool

Our new prior authorization code lookup tool is coming soon, learn more.

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Pharmacy Preferred Newsletter
Pharmacy Preferred Newsletter

Our November 2021 Pharmacy Preferred Newsletter is now available.

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Billing and Rendering Taxonomy Requirements
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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SHINGRIX Vaccine
SHINGRIX Vaccine

Shingrix Vaccine is recommended in adults age 50 and older.

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Online Provider Search Tool
Online Provider Search Tool

Learn about the new provider search tool coming in July.

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ERA Enrollment Process
ERA Enrollment Process

The enrollment process is all electronic and does not require a fee to register or enroll.

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Medicare Programs Innovations
Medicare Programs Innovations

New enriched benefits and reduced cost-sharing for chronic conditions

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Our New Medicare Name
Our New Medicare Name

Community HealthFirst Medicare Advantage is now Community Health Plan of Washington Medicare Advantage

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Improving Physical Accessibility
Improving Physical Accessibility

This CMS guide shows recommendations for improving access and quality of care for patients with disabilities.

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New Add Change Term Forms Available
New Add Change Term Forms Available

New Add Change forms are available online. Use this form to notify us of changes in your information.

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