Where to refer Apple Health clients to update their TPL information

Washington State Health Care Authority sent this bulletin at 05/16/2024 10:00 AM PDT

May 16, 2024

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Updating third-party liability information

The Health Care Authority’s (HCA) Coordination of Benefits (COB) Unit has received multiple reports that Apple Health (Medicaid) clients enrolled in a managed care plan are being referred to HCA to update their third-party liability (TPL) information.

Clients enrolled in managed care should be directed to contact their plan’s Apple Health managed care plan's customer service to add, update, or correct private insurance information.

If providers encounter claims billing issues for clients with private insurance who have Apple Health managed care, the health plan should be contacted directly to resolve the issue. If the client has an urgent prescription need, providers should refer to the managed care plan’s emergency prescription fill policy.

Contact

For clients enrolled in Apple Health managed care, contact their health plan.
For clients enrolled in fee-for-service (FFS), contact HCA.
- Select "I am an Apple Health (Medicaid) biller or provider."
- Select "Provider online form."
- From the drop down menu, select "Private Commercial Insurance."

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

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.