Billing Guide Updates, effective 10/1/18 and IMC Changes for 1/1/2019

Washington State Health Care Authority sent this bulletin at 09/26/2018 04:14 PM PDT

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Apple Health (Medicaid) Provider Alert

Quarterly billing guide updates, effective October 1, 2018
Effective October 1, 2018, the Health Care Authority (HCA) is publishing quarterly updates to most of the Washington Apple Health billing guides. Billing guides are located on HCA’s Provider billing guides and fee schedule web page. Check the web page often. HCA is loading the revised billing guides as soon as they are finalized for publishing.

Changes coming to Washington Apple Health, effective January 1, 2019
Effective January 1, 2019, Apple Health managed care plans will begin covering behavioral health services (mental health and substance use disorder treatment), along with the currently covered physical health services.

To view a map and table of the integrated managed care plans available within each region, please see Changes coming to Washington Apple Health. You may also refer to the agency’s Apple Health managed care webpage.

Apple Health clients without managed care plans (e.g., dual-eligible Medicare-Medicaid clients) will still have behavioral health coverage through one of the new integrated managed care plans. However, their plan will cover behavioral health services only.

Most clients will remain with the same health plan, except in regions where clients’ plans will no longer be available. HCA will auto-enroll these clients to one of the offered plans.

Clients can change their plan at any time by:

Visiting the ProviderOne Client Portal .
Calling Apple Health Customer Service toll-free at 1-800-562-3022. This automated system is available 24 hours a day, 7 days a week.
Requesting a change online through our secure Contact us – Apple Health (Medicaid) client web form.
Select the topic “Enroll/Change Health Plans.”
Visiting the Washington Healthplanfinder (only for clients with a Washington Healthplanfinder account).

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than two million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, and, beginning in 2020, the School Employees Benefits Board (SEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.