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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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