Directory of Services and Contacts
Community Health Plan
720 Olive Way, Suite 300
Seattle, WA 98101
Phone 206-521-8830 local or 1-800-440-1561 toll free
Fax 206-521-8834
Web www.chpw.org
Community Health Plan Contacts
Please note that most contact numbers are triaged through Customer Service.
| Service | Contact Information |
|---|---|
| General Customer Service Monday through Friday, 8 am to 5 pm Benefits and eligibility verification, enrollee lists, PCP changes, provider participation status, enrollee and provider complaints | 206-521-8830 1-800-440-1561 toll free 1-866-816-2479 TTY/TDD |
| Medicare Customer Service Sunday through Saturday, 8 am to 8 pm Benefits and eligibility verification, enrollee lists, PCP changes, provider participation status, enrollee and provider complaints. | 1-800-942-0247 toll free 1-866-816-2479 TTY/TDD |
| Provider Relations Monday through Friday, 8 am to 5 pm General questions about the policies and procedures, contract questions, updates to clinic and PCP information, credentialing | 206-521-8830 1-800-440-1561 toll free 206-613-5018 fax |
| Referrals | 1-800-440-1561 toll free 206-652-7076 fax |
| Medical Management Monday through Friday, 8 am to 5 pm Prior authorizations, case management, disease management, care management, pharmacy management, quality improvement, and utilization management. Customer Service toll-free number is available to accept collect calls regarding utilization management (UM) issues. UM staff is accessible to callers who have questions about the UM process. | 206-521-8833 1-800-440-1561 toll free |
| Submission of medical prior authorizations requests | 206-613-8873 fax |
| Submission of inpatient hospital notifications | 206-652-7078 fax |
| Appeals and grievances | 206-521-8830 206-613-8983 fax 206-613-8984 fax |
Additional Contacts Outside of Community Health Plan
| Service | Contact Information |
|---|---|
| Pharmacy Benefits Manager—Express Scripts, Inc. For Basic Health, Healthy Options, SCHIP, Disability Lifeline For Medicare | 1-888-256-6132 1-800-417-8164 |
| Eligibility and Claims | One Health Port |
| All Claims Mail all paper claims to | CHP Claims PO Box 269002 Plano, Texas 75026-9002 |
| Electronic Claims | Dell and Adaptis accept professional claims via the Availity clearinghouse. Please use Community Health Plan's Payer Identifier: CHPWA. If you currently submit claims via Emdeon, you can submit to Community Health Plan electronically via Availity by using the Community Health Plan Emdeon payer ID# of SB613 for 839Ps or 12T30 for 837Is. |
| Claims Questions Monday through Friday, 8 am to 5 pm | 1-800-440-1561 |
| HRSA web site | http://fortress.wa.gov/dshs/maa/ |
| HCA web site | http://www.hca.wa.gov/ |
| CMS web site | http://www.cms.hhs.gov/ |