TurningPoint Healthcare Solutions

Coordinated Care of Washington, Inc has contracted with TurningPoint Healthcare Solutions, LLC,  (TP) for the new Musculoskeletal Surgical Quality and Safety Management Program, effective September 1, 2019, for Apple Health (Medicaid).

The program is designed to work collaboratively with physicians to promote patient safety through the practice of high quality and cost-effective care for Coordinated Care members. TurningPoint policies can be found on their portal at www.myturningpoint-healthcare.com or by calling 206-486-3946 or 844-245-6519.

A training webinar recording is available online. Visit the link below and register to view the previously recorded webinar training.

Musculoskeletal Surgical Quality and Safety Management Recorded Webinar

Coordinated Care oversees the Musculoskeletal Surgical Quality and Safety Management Program and is responsible for claims adjudication and appeals. Prior Authorization for medical necessity and appropriate length of stay (when applicable) has been delegated to TurningPoint Healthcare Solutions, LLC, and will be required for the following surgical procedures in both inpatient and outpatient settings effective September 1, 2019.

Prior authorization can be requested starting August 15, via phone 206-486-3946 or 844-245-6519, fax (206-788-8673) or TurningPoint’s Web portal found at www.myturningpoint-healthcare.com.

All Turning Point authorization reconsiderations and peer-to-peer requests can be made by calling 800-581-3920.

To request access to the TurningPoint Web portal, call the phone numbers listed above.     

Musculoskeletal

Orthopedic Surgical Procedures

Including all associated partial, total, and revision surgeries

  • Knee Arthroplasty
  • Unicompartmental/Bicompartmental Knee Replacement
  • Hip Arthroplasty\
  • Shoulder Arthroplasty
  • Elbow Arthroplasty
  • Ankle Arthroplasty
  • Wrist Arthroplasty
  • Acromioplasty and Rotator Cuff Repair
  • Anterior Cruciate Ligament Repair
  • Knee Arthroscopy
  • Hip Resurfacing
  • Meniscal Repair
  • Hip Arthroscopy
  • Femoroacetabular Arthroscopy
  • Ankle Fusion
  • Shoulder Fusion
  • Wrist Fusion
  • Osteochondral Defect Repair
     

 

Spinal Surgical Procedures

Including all associated partial, total, and revision surgeries

  • Spinal Fusion Surgeries
    • Cervical
    • Lumbar
    • Thoracic
    • SacralScoliosis
  • Disc Replacement 
  • Laminectomy/Discectomy 
  • Kyphoplasty/Vertebroplasty 
  • Sacroiliac Joint Fusion 
  • Implantable Pain Pumps 
  • Spinal Cord Neurostimulator 
  • Spinal Decompression
     

NOTE: Always verify current authorization status in the Prior Authorization tool.