Access Washington Home
STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
Aging and Long-Term Support Administration
Home and Community Services Division
PO Box 45600, Olympia, WA 98504-5600
H17-032 - Procedure
May 01, 2017
|TO: |Area Agency on Aging (AAA) Directors |
| | |
| |Home and Community Services (HCS) Division Regional Administrators |
| | |
| |Developmental Disabilities Administration (DDA) Regional Administrators |
|FROM: |Bea Rector, Director, Home and Community Services Division |
| | |
| |Don Clintsman, Deputy Assistant Secretary, Developmental Disabilities Administration |
|SUBJECT: |Apple Health Managed Care (AHMC) contacts for care coordination and authorization assistance |
|Purpose: |To provide staff with contacts and process for contacting AHMC plans to assist in client care coordination. |
|Background: |The AH managed care program is a managed medical care program that serves over 1.7 million Medicaid clients |
| |statewide. This program is administered by the Health Care Authority (HCA) and, via contracts with managed care |
| |health plans, provides comprehensive medical care including preventative, primary, specialty, mental and ancillary |
| |health services to all eligible clients in the state. Medicaid clients are also enrolled in a Behavioral Health |
| |Organization (BHO) to meet their additional mental health needs not covered in the AHMC contract in most of the |
| |state. Individuals may be enrolled in a BHO and AHMC at the same time to cover separate benefits. |
| | |
| |Clients enrolled in managed care (AHMC and BHO) continue to receive home and community based services on a |
| |fee-for-service basis through HCS/AAA/DDA; only Apple Health and BHO covered services will be provided by the managed|
| |care plan and BHO assigned to each client. |
| | |
| |Note: SW WA (Clark and Skamania counties) have a model of care where all Medical and Behavioral Health are purchased |
| |through one managed care contract, this is called fully integrated managed care (FIMC). |
| | |
|What’s New, changed, or |This management bulletin is to provide resources for how to contact the AHMC plans to assist in care coordination for|
|Clarified: |clients we serve. |
| |The department has established the following processes with the Healthcare Authority contracted Apple Health Managed |
| |Care Organizations (MCOs) to facilitate information sharing related to treatment, authorizations and care |
| |coordination activities for MCO enrolled clients that you are case managing. |
| | |
| |Coordinated Care of Washington (CCW) |
| | |
| |Contact customer service 1-877-644-4613 |
| |Authorization department: 1-877-644-4613 ext 69617 |
| |Verify password: Panda |
| |Provide member/client specific information/identifiers (will be asked for name, P1/plan id/SSN, DOB) |
| | |
| |Amerigroup (AMG): |
| | |
| |Contact customer service 1-800-600-4441 |
| |No password needed |
| |Provide the member/client information. |
| | |
| |Community Health Plan of Washington (CHPW) |
| | |
| |Contact customer service 1-800-440-1561 |
| |Verify Password: MISSION |
| |Provide member/client specific information/identifiers |
| | |
| |Molina Healthcare (MHC) |
| | |
| |Contact customer service 1-800-869-7165 |
| |Authorization department 1-800-869-7175 |
| |Verify Password: CLEO |
| |Provide member specific information/identifiers |
| | |
| |United Healthcare (UHC): |
| | |
| |For authorizations or care coordination issues please contact: |
| |Primary: Marci Brand marci_brand@ 952-202-4875 |
| |Backup: Cindy Spain cindy_l_spain@ 206-926-0222 |
| | |
| |If you experience any issues with this process please contact Kelli Emans who can be reached at the e-mail address or|
| |phone number below. |
|ACTION: |Use these contacts for care coordination |
|RELATED REFERENCES: |N/A |
|CONTACT(S): |Kelli Emans - Managed Care Policy |
| |Kelli.emans@dshs. |
| |360-725-3212 |
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