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State of Emergency Regarding Washington Wildfires

Date: 08/02/18

Due to fires in the State of Washington, Governor Jay Inslee declared a state of emergency for the entire state. Please note that we have removed the refill too soon edit as well as requirements for out-of-network provider authorizations. Prior authorization for medication may still be needed for medical necessity. For refill too soon rejections, please use Submission Clarification Code 13 in order to receive a paid claim.

This change is in effect until the emergency notice is closed, or August 30, 2018 , whichever is earlier.

If you need an override for a member please call the following service lines (urgent calls triage to Nurse Advice Line 24/7):

  • Apple Health members: 1-877-644-4613 (TTY/TDD: 1-866-862-9380); staffed Monday-Friday 8:00am-5:00pm
  • Apple Health Core Connections: 1-844-354-9876 (TTY/TDD: 711); staffed Monday-Friday 8:00am-5:00pm
  • Ambetter: 1-877-687-1197 (TTY/TDD 1-877-941-9238); staffed Monday-Friday 8:00am-5:00pm

Wildfire Information and Resources

Governor Inslee’s Washington Wildfire Resources and Updates

Washington Smoke Information Blog

Wildfire FAQ's

Who can I contact if I have a question? 

  • Member Services
    • Apple Health members: 1-877-644-4613 (TTY/TDD: 1-866-862-9380); staffed Monday-Friday 8:00am-5:00pm; urgent calls triage to Nurse Advice Line 24/7.
    • Apple Health Core Connections: 1-844-354-9876 (TTY/TDD: 711); staffed Monday-Friday 8:00am-5:00pm; urgent calls triage to Nurse Advice Line 24/7. (This has also been shared with Meri Waterhouse – Children’s Administration).
    • 24-hour Nurse Advice Line: 1-877-644-4613
  • Provider Services
    • AHMC: 1-877-644-4613 (TTY/TDD: 1-866-862-9380); staffed Monday-Friday 8:00am-5:00pm; urgent calls triage to Nurse Advice Line 24/7
    • AHFC: 1-844-354-9876 (TTY/TDD: 711); staffed Monday-Friday 8:00am-5:00pm; urgent calls triage to Nurse Advice Line 24/7

If I can reach anyone at Coordinated Care, are there other groups I can work with? 

  • We are reaching out to Fostering Together, Fostering Washington, and the Foster Parent email list with our information for members affected by the wild fires. We are also offering help to local partners and Health Centers (CHCs).
  • We are providing office hours at CHCs and helping organizations with information. We are also helping members get new ID cards, and connecting them to health plan and community services.

The smoke is making my, or my family member’s, disease symptoms worse. Will someone be able to guide me where to go for care?

  • For those members in Care Management who are at the most risk, we are reaching out to provide help. We are making sure the member knows and understands their respiratory status. We will also guide them to go to their Primary Care Provider (PCP), Urgent Care, or Emergency Room (ER) for treatment, if needed.  

What if I have to leave my area and can’t visit my doctor or pharmacy to refill my prescription? Or, what if they are closed because of the fires?

  • We informed providers and pharmacies that out of network authorizations can be allowed
  • We identified our members who may need fast track authorizations. We will also track new requests to make sure they are processed quickly 
  • Where needed, pharmacies are instructed to allow:
    • Up to a 30-day emergency medication supply if requested
    • Emergency prescriptions written by our medical team
    • Overnight shipments

I know that some services normally need an authorization request, such as early prescription refills. Which services still require a request during a wildfire? 

  • Some authorizations change status during a disaster, while others remain in effect. The list below describes what you need to know about certain services
    • Altered authorizations during a wildfire disaster:
      • Where needed, pharmacies are instructed to allow:
        • Up to a 30-day emergency medication supply if requested
        • Emergency prescriptions written by our medical team
        • Overnight shipments
      • Out of network provider visits
    • Authorizations needed during a wildfire disaster:
      • Medical services or medication for medical necessity
        • We will process these requests as ‘urgent’ during a wildfire disaster
    • *These changes will remain in effect until the emergency no longer exists, or 90 days after the emergency has been declared

Will my doctor know that I may need to use a different source for my prescription, or that I may need an early refill?

  • We informed providers and pharmacies that early refills and out of network authorizations can be allowed

What should I do to keep my family healthy when a wildfire is in my area? 

  • Air quality can be poor from the wildfire smoke. Common symptoms include: headache, dizziness, congestion, cough, runny nose, watery eyes, and shortness of breath
  • To avoid these symptoms, drink lots of water and stay indoors as much as possible. If possible, use air conditioning instead of opening windows to keep cool
  • If possible, use an air cleaner with a HEPA filter in order to create a ‘clean room.’ This room should not have a fireplace, and few windows or doors
  • Have necessary medication and supplies stocked up when possible

Who is most at risk to wildfire smoke? 

  • Children under 18 and adults over 65
  • People with heart and lung diseases
  • People with illnesses and colds
  • People who have had a stroke
  • Pregnant women
  • People who smoke