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Insurance Claims

The WSMA continues to hear from physicians and practice managers regarding unresolved claims problems with health plans.

To better assist our members in addressing these concerns, the WSMA is pleased to advocate on behalf of physicians and practices to resolve claims issues.

Insurance claim assistance request

When you encounter problems with a specific insurance claim, use the WSMA's insurance claim assistance request (ICAR) form below to advise the WSMA of the issue and to prompt action. The WSMA will facilitate communication between the physician's practice and appropriate parties at the health plan to seek resolution.

The WSMA's insurance claims assistance program is in compliance with HIPAA privacy regulations to protect any patient health information we receive from WSMA members. Before sending us a patient's PHI, the WSMA will need to receive a signed business associate agreement, also below.

Upon receipt of your completed ICAR form and a signed business associate agreement, the WSMA will track each request and forward a copy to the relevant health plan. We'll ask the health plan to act upon that request to resolve the claim and to advise the WSMA of their actions. We will forward a copy of the health plan's response to the inquiring physician.

WSMA insurance claim assistance is available only to WSMA member physicians and their practice staff. For more information, contact Bob Perna at 206.441.9762/800.552.0612 or rjp@wsma.org.

Download a WSMA Insurance Claim Assistance Request Form.
Download a WSMA Business Associate Agreement.

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