The ProviderOne system will be undergoing maintenance from 6 a.m. to 10 a.m. Sunday, September 15, 2024 (4 hours). Although we do not expect the maintenance activity to result in a full outage, there is the potential for intermittent outages or degraded performance during the maintenance period.
This outage does not affect the Pharmacy POS
Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.
Tribal affairs
The Office of Tribal Affairs (OTA) exists to support, strengthen, and honor our state’s government-to-government relationship and unique partnership with Tribes. We work to ensure Washington state recognizes and protects the interests, rights, and sovereignty of Tribal Nations.
We serve and work alongside Tribes and other partners to support the health and well-being of American Indian and Alaska Native people. Some of this work includes:
- Health care coverage options
- Mental health and substance use disorder prevention, treatment, and recovery support
- Crisis services
- Transitional care planning
- Peer counseling
In addition, we partner, convene, facilitate, create policies and programs, train, support, and oversee agency efforts related to Tribes, Urban Indian Health Programs, Indian health care providers, and Tribal-serving organizations.
How do I?
- View upcoming meetings, including Roundtables and Consultations
- Find the nearest Tribal or urban Indian clinic
- Find Tribal billing resources
- Sign up to receive the Tribal Bulletin or other Tribal-related communications
- Read a recent Dear Tribal Leader Letter
- Learn more about Apple Health (Medicaid)
- Sign up for Apple Health
American Society of Addiction Medicine (ASAM)
The ASAM Criteria defines the treatment criteria and levels of care for the treatment of substance-related and co-occurring conditions. The ASAM Criteria structure is the underlying framework for our service codes (billing guides), fiscal assumptions (rates), etc.
Under state law, licensed behavioral health agencies (BHA) providers are required to use The ASAM Criteria. Managed care organizations (MCOs), behavioral health administrative services organizations (BH-ASOs) contracted by the Health Care Authority (HCA), and private insurance plans use The ASAM Criteria as a utilization management tool.
The ASAM Criteria, 4th Edition, Volume 1, Adults is now available.
Want to stay up to date on the ASAM?
4th edition timeline
SB 5361 passed in the 2025 legislative session, delaying the adoption date until January of 2028.
Read the ASAM adoption readiness FAQ
While the adoption date is delayed, clinicians are encouraged to continue to work on quality improvement and attend trainings through June of 2025.
Training courses will:
- Be held virtually.
- Start in July 2024 and run through June 2025.
- Be offered by the Train for Change Company and free of charge (funded by the Washington State Legislature and State Opioid Response Grant).
The Adolescent and Transition Age Youth version is anticipated to be released in 2026.
4th edition trainings
Tier 1: The Evolution of The ASAM Criteria: What’s New in the 4th Edition.
This is a great training for a broad audience who works in the field and wants a consolidated overview of the ASAM updates. Tier 1 training is for anyone and everyone in the behavioral health field.
Tier 2: Two-day ASAM Criteria 4th Edition Skill-building Training
This is a prerequisite for Tier 3 training. Tier 2 training will benefit clinicians who are newer to the field or are substance use disorder professionals who would benefit from an in-depth course.
Tier 3: Implementation, Improvement, Sustainability, and Coaching of The ASAM Criteria. A “How to,” Science-based Approach.
This training is designed for clinical supervisors, directors, administrators, and decision makers who play a key role in implementation and ongoing support of adopting the changes within their organization.
How do I participate in trainings?
- Read the 4th edition ASAM FAQ.
- Select the training that you want to attend.
- Sign up using the email address for the location where you will attend the virtual training.
- Once registered, you will receive an email confirmation.
- Spots are limited. Please reach out to the contact person on the confirmation email to cancel the training if you cannot attend.
All trainings are offered by the Train for Change company. Although the trainings are free of charge, you will need to purchase The ASAM Criteria, 4th Edition.
The ProviderOne system will be undergoing maintenance from 3 p.m. to 8 p.m. Saturday, August 24, 2024 (5 hours). Although we do not expect the maintenance activity to result in a full outage, there is the potential for an intermittent outage or degraded performance during the maintenance period.
This maintenance does not affect the Pharmacy POS
Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.
Vision
The Public Employees Benefits Board (PEBB) Program provides a variety of vision plans for PEBB employers.
Plan availability
Standalone vision plans offered by the PEBB Program are available to all benefits eligible employees whose employer offers the full benefits package. These vision plans are not available to employer groups who offer the medical only benefits package.
Effective January 1, 2025, routine vision coverage is separate from medical coverage.
Before selecting a plan or provider, employees should compare vision plans to find out what services are covered, which providers are in-network, and the costs for care.
What do the vision plans cover?
- Each plan will have a network of providers that offers services like routine eye exams, eyeglass frames and lenses, contact lenses, and discounts on treatments like LASIK.
- All plans will offer private practice optometrists and ophthalmologists in Washington State and nationwide, but each plan’s network will include different providers. These plans were chosen to cover as many counties in Washington as possible, but not all plans will have network providers in all areas.
- In addition to private practice locations, each plan will offer a selection of retail locations, such as Costco Optical, Walmart, Sam’s Club, America’s Best, Visionworks, LensCrafters, Pearle Vision, and Target Optical.
PEBB Program vision plans
- Davis Vision by MetLife
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Davis Vision is underwritten by the Metropolitan Life Insurance Company (MetLife).
Plan documents
Davis Vision Certificate of Coverage (COC)
Preauthorization criteria
Preauthorization is when a covered individual seeks approval from their health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that the plan will pay for those services, supplies, or drugs.
Davis Vision preauthorization criteria
These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.
Find a provider
Visit the Davis Vision provider directory.
Contact information
Phone: 1-877-377-9353 (TTY: 1-800-523-2847)
Online: Davis Vision - EyeMed
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EyeMed Vision Care is underwritten by Fidelity Security Life Insurance Company (FSL).
Plan documents
EyeMed Vision Certificate of Coverage (COC)
Preauthorization criteria
Preauthorization is when a covered individual seeks approval from their health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that the plan will pay for those services, supplies, or drugs.
EyeMed Vision Care preauthorization criteria
These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.
Find a provider
Visit the EyeMed Vision Care provider directory.
Contact information
Phone: 1-800-699-0993 (TTY: 1-800-699-0993)
Online: EyeMed Vision Care - MetLife Vision
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Plan documents
MetLife Vision Certificate of Coverage (COC)
Preauthorization criteria
Preauthorization is when a covered individual seeks approval from their health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that the plan will pay for those services, supplies, or drugs.
MetLife Vision preauthorization criteria
These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.
Find a provider
Visit the MetLife Vision provider directory.
Contact information
Phone: 1-855-638-3931 (TTY: 1-800-428-4833)
Online: MetLife Vision
Member ID cards
Once a member is enrolled in vision, no matter what the carrier/plan, members are sent a welcome packet that includes two copies of an ID card with the subscribers name.
Welcome packets also include instructions on how to set up an online account, where members can download and print additional copies of cards, access forms, and check eligibility and benefits.
Members do not need to present an ID card in order to receive services. In-network providers have access to secure portals to look up eligibility and benefit information based on the subscribers name.