emergency room provider directory · 1/14/2020 · odessa wa odessa memorial healthcare center...
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans
Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise HealthPlan of Washington Preferred Network
1
To make sure your benefits cover ER services at their highest level, use the following list to see if the ER physicians group serving our participating hospitals is in-network.
The cost to you for receiving ER services from an out-of-network ER physicians group may be higher even when received at an in-network hospital. Table of Contents:
Section 1: LifeWise HealthPlan of Washington Preferred Network
Section 2: LifeWise Primary Network
Section 3: LifeWise Alpine Network
Section 1: LifeWise HealthPlan of Washington Preferred Network
City State In-Network Hospital ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Olympia WA Capital Medical Center Thurston Emergency Group In-Network
Leavenworth WA Cascade Medical Center Cascade Medical Center In-Network
Arlington WA Cascade Valley Hospital Northwest Emergency Physicians In-Network
Wenatchee WA Central Washington Hospital Central Washington Hospital In-Network
Ephrata WA Columbia Basin Hospital Beezley Springs Inpatient Services In-Network
Astoria OR Columbia Memorial Hospital Oregon Health & Science University (OHSU) Out-of-Network
Grand Coulee WA Coulee Medical Center Coulee Medical Center In-Network
Dayton WA Dayton General Hospital Dayton General Hospital In-Network
Ritzville WA East Adams Rural Hospital East Adams Rural Hospital In-Network
Kirkland WA EvergreenHealth Medical Center Evergreen Emergency Services In-Network
Monroe WA EvergreenHealth Monroe North Sound Emergency Medicine In-Network
Republic WA Ferry County Memorial Hospital Ferry County Memorial Hospital In-Network
Forks WA Forks Community Hospital Forks Community Hospital In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans
Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise HealthPlan of Washington Preferred Network
2
City State In-Network Hospital ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Pomeroy WA Garfield County Memorial Hospital Garfield County Memorial Hospital In-Network
Aberdeen WA Grays Harbor Community Hospital Northwest Emergency Physicians In-Network
Moscow ID Gritman Medical Center Gritman Medical Center In-Network
Seattle WA Harborview Medical Center Emergency Department at Harborview In-Network
Bremerton WA Harrison Medical Center West Sound Emergency Physicians In-Network
Silverdale WA Harrison Medical Center West Sound Emergency Physicians In-Network
Anacortes WA Island Hospital Northwest Emergency Physicians In-Network
Port Townsend WA Jefferson Healthcare Hospital Jefferson Healthcare Hospital In-Network
Walla Walla WA Jonathan M Wainwright Memorial VA Medical Center ER services are not offered at this facility.
Richland WA Kadlec Regional Medical Center Northwest Emergency Physicians In-Network
Kennewick WA Kadlec (Free-Standing) Emergency Room in Kennewick Northwest Emergency Physicians In-Network
Ellensburg WA Kittitas Valley Community Hospital Kittitas Valley Community Hospital In-Network
Goldendale WA Klickitat Valley Hospital Klickitat Valley Hospital In-Network
Coeur D’Alene ID Kootenai Health Kootenai Health In-Network
Chelan WA Lake Chelan Community Hospital Lake Chelan Community Hospital In-Network
Vancouver WA Legacy Salmon Creek Hospital Northwest Acute Care Specialists Out-of-Network
Davenport WA Lincoln Hospital Lincoln Hospital In-Network
Pasco WA Lourdes Medical Center Northwest Emergency Physicians In-Network
Tacoma WA Mary Bridge Children’s Hospital and Health Center Mary Bridge Emergency Department In-Network
Shelton WA Mason General Hospital Mason General Hospital In-Network
Omak WA Mid Valley Hospital Mid Valley Hospital In-Network
Morton WA Morton General Hospital Morton General Hospital In-Network
Tacoma WA MultiCare Allenmore Hospital Tacoma Emergency Care Physician In-Network
Auburn WA MultiCare Auburn Medical Center Cascade Emergency Physicians In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans
Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise HealthPlan of Washington Preferred Network
3
City State In-Network Hospital ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Covington WA MultiCare Covington Medical Center Tacoma Emergency Care Physician In-Network
Spokane WA MultiCare Deaconess Hospital Spokane Emergency Care Physicians In-Network
Spokane WA MultiCare Deaconess North (Free-Standing) Emergency Center
Spokane Emergency Care Physicians In-Network
Puyallup WA MultiCare Good Samaritan Hospital Mt. Rainier Emergency Physicians In-Network
Parkland WA MultiCare Good Samaritan (Free-Standing) Emergency Western Washington Emergency Physicians In-Network
Tacoma WA MultiCare Tacoma General Hospital Tacoma Emergency Care Physician In-Network
Spokane WA MultiCare Valley Hospital Spokane Emergency Care Physicians In-Network
Newport WA Newport Community Hospital Newport Community Hospital In-Network
Tonasket WA North Valley Hospital North Valley Hospital In-Network
Ilwaco WA Ocean Beach Hospital Ocean Beach Hospital In-Network
Odessa WA Odessa Memorial Healthcare Center Odessa Memorial Healthcare Center In-Network
Port Angeles WA Olympic Medical Center Olympic Medical Center In-Network
Othello WA Othello Community Hospital Othello Community Hospital In-Network
Bellevue WA Overlake Hospital Medical Center Puget Sound Physicians In-Network
Friday Harbor WA PeaceHealth Peace Island Medical Center PeaceHealth Peace Island Medical Center In-Network
Vancouver WA PeaceHealth Southwest Medical Center Emergency Medicine Associates Out-of-Network
Bellingham WA PeaceHealth St Joseph Medical Center Northwest Emergency Physicians In-Network
Sedro Woolley WA PeaceHealth United General Hospital Sound Physicians of Emergency Medicine of Washington Out-of-Network
Prosser WA Prosser Memorial Hospital Prosser Memorial Hospital In-Network
Centralia WA Providence Centralia Hospital Northwest Emergency Physicians In-Network
Spokane WA Providence Holy Family Hospital Emergency Physician Services In-Network
Colville WA Providence Mount Carmel Hospital Providence Mount Carmel Hospital In-Network
Everett WA Providence Regional Medical Center Everett Colby Campus
North Sound Emergency Medicine In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans
Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise HealthPlan of Washington Preferred Network
4
City State In-Network Hospital ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Spokane WA Providence Sacred Heart Medical Center and Children’s Hospital
Spokane Emergency Physicians In-Network
Chewelah WA Providence St. Joseph’s Hospital Providence St. Joseph’s Hospital In-Network
Walla Walla WA Providence St. Mary Medical Center Providence St. Mary Medical Center In-Network
Olympia WA Providence St. Peter Hospital Olympia Emergency Service In-Network
Pullman WA Pullman Regional Hospital Pullman Regional Hospital In-Network
Quincy WA Quincy Valley Hospital Quincy Valley Hospital In-Network
Moses Lake WA Samaritan Hospital Samaritan Hospital In-Network
Seattle WA Seattle Cancer Care Alliance ER services are not offered at this facility.
Seattle WA Seattle Children’s Hospital Seattle Children’s Hospital In-Network
Toppenish WA SHC Medical Center Toppenish Olney Emergency Group In-Network
Spokane WA Shriners Hospital for Children ER services are not offered at this facility.
Mount Vernon WA Skagit Valley Hospital Northwest Emergency Physicians In-Network
White Salmon WA Skyline Hospital Skyline Hospital In-Network
Snoqualmie WA Snoqualmie Valley Hospital Snoqualmie Valley Hospital In-Network
Spokane WA Spokane VA Medical Center ER services are not offered at this facility.
Burien WA St. Anne Hospital Highline Emergency Physicians In-Network
Gig Harbor WA St. Anthony Hospital Northwest Emergency Physicians In-Network
Lakewood WA St. Clare Hospital Northwest Emergency Physicians In-Network
Enumclaw WA St. Elizabeth Hospital Northwest Emergency Physicians In-Network
Federal Way WA St. Francis Community Hospital Northwest Emergency Physicians In-Network
Longview WA St. John Medical Center St John’s Emergency Physicians In-Network
Tacoma WA St. Joseph Medical Center Northwest Emergency Physicians In-Network
Elma WA Summit Pacific Medical Center Summit Pacific Medical Center In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans
Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise HealthPlan of Washington Preferred Network
5
City State In-Network Hospital ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Sunnyside WA Sunnyside Community Hospital Sunnyside Emergency Group In-Network
Edmonds WA Swedish Edmonds California Emergency Physicians In-Network
Seattle WA Swedish Medical Center Ballard Ballard Emergency Physicians In-Network
Seattle WA Swedish Medical Center Cherry Hill Seattle Emergency Physicians In-Network
Seattle WA Swedish Medical Center First Hill Seattle Emergency Physicians In-Network
Issaquah WA Swedish Medical Center Issaquah Eastside Emergency Physicians In-Network
Mill Creek WA Swedish Mill Creek Campus (Free-standing Emergency Room)
Eastside Emergency Physicians In-Network
Redmond WA Swedish Redmond Campus (Free-standing Emergency Room)
Eastside Emergency Physicians In-Network
Brewster WA Three Rivers Hospital Three Rivers Hospital In-Network
Clarkston WA Tri-State Memorial Hospital Tri-State Memorial Hospital In-Network
Kennewick WA Trios Southridge Hospital Columbia Valley Emergency Physicians In-Network
Seattle WA University of Washington Medical Center – Montlake Campus
Emergency Department at UWMC In-Network
Seattle WA University of Washington Medical Center – Northwest Campus
Emergency Department at UWMC In-Network
Tacoma WA VA Puget Sound Health Care Services - American Lake Division
ER services are not offered at this facility.
Seattle WA VA Puget Sound Health Care System - Seattle ER services are not offered at this facility.
Renton WA Valley Medical Center Associated Emergency Physicians In-Network
Seattle WA Virginia Mason Hospital and Medical Center Virginia Mason Hospital and Medical Center In-Network
Yakima WA Virginia Mason Memorial Hospital Virginia Mason Memorial Hospital In-Network
Wenatchee WA Wenatchee Valley Hospital Wenatchee Valley Hospital In-Network
Coupeville WA WhidbeyHealth Medical Center WhidbeyHealth Medical Center In-Network
Colfax WA Whitman Hospital and Medical Center Whitman Hospital and Medical Center In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans
Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise HealthPlan of Washington Preferred Network
6
City State In-Network Hospital ER Physician Group Servicing the Hospital ER Physician Group
Network Status
South Bend WA Willapa Harbor Hospital Willapa Harbor Hospital In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise Primary Network 7
Section 2: LifeWise Primary Network
City State Hospitals In-Network ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Leavenworth WA Cascade Medical Center Cascade Medical Center In-Network
Arlington WA Cascade Valley Hospital Northwest Emergency Physicians In-Network
Wenatchee WA Central Washington Hospital Central Washington Hospital In-Network
Ephrata WA Columbia Basin Hospital Beezley Springs Inpatient Services In-Network
Astoria OR Columbia Memorial Hospital Oregon Health & Science University (OHSU) Out-of-Network
Grand Coulee WA Coulee Medical Center Coulee Medical Center In-Network
Dayton WA Dayton General Hospital Dayton General Hospital In-Network
Ritzville WA East Adams Rural Hospital East Adams Rural Hospital In-Network
Republic WA Ferry County Memorial Hospital Ferry County Memorial Hospital In-Network
Forks WA Forks Community Hospital Forks Community Hospital In-Network
Pomeroy WA Garfield County Memorial Hospital Garfield County Memorial Hospital In-Network
Aberdeen WA Grays Harbor Community Hospital Northwest Emergency Physicians In-Network
Moscow ID Gritman Medical Center Gritman Medical Center In-Network
Bremerton WA Harrison Medical Center West Sound Emergency Physicians In-Network
Silverdale WA Harrison Medical Center West Sound Emergency Physicians In-Network
Anacortes WA Island Hospital Northwest Emergency Physicians In-Network
Port Townsend WA Jefferson Healthcare Hospital Jefferson Healthcare Hospital In-Network
Walla Walla WA Jonathan M Wainwright Memorial VA Medical Center ER services are not offered at this facility.
Richland WA Kadlec Regional Medical Center Northwest Emergency Physicians In-Network
Kennewick WA Kadlec (Free-Standing) Emergency Room in Kennewick
Northwest Emergency Physicians In-Network
Ellensburg WA Kittitas Valley Community Hospital Kittitas Valley Community Hospital In-Network
Goldendale WA Klickitat Valley Hospital Klickitat Valley Hospital In-Network
Coeur D’Alene ID Kootenai Health Kootenai Health In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise Primary Network 8
City State Hospitals In-Network ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Chelan WA Lake Chelan Community Hospital Lake Chelan Community Hospital In-Network
Vancouver WA Legacy Salmon Creek Hospital Northwest Acute Care Specialists Out-of-Network
Davenport WA Lincoln Hospital Lincoln Hospital In-Network
Pasco WA Lourdes Medical Center Northwest Emergency Physicians In-Network
Shelton WA Mason General Hospital Mason General Hospital In-Network
Omak WA Mid Valley Hospital Mid Valley Hospital In-Network
Morton WA Morton General Hospital Morton General Hospital In-Network
Newport WA Newport Community Hospital Newport Community Hospital In-Network
Tonasket WA North Valley Hospital North Valley Hospital In-Network
Ilwaco WA Ocean Beach Hospital Ocean Beach Hospital In-Network
Odessa WA Odessa Memorial Healthcare Center Odessa Memorial Healthcare Center In-Network
Port Angeles WA Olympic Medical Center Olympic Medical Center In-Network
Othello WA Othello Community Hospital Othello Community Hospital In-Network
Friday Harbor WA PeaceHealth Peace Island Medical Center PeaceHealth Peace Island Medical Center In-Network
Vancouver WA PeaceHealth Southwest Medical Center Emergency Medicine Associates Out-of-Network
Bellingham WA PeaceHealth St. Joseph Medical Center Northwest Emergency Physicians In-Network
Sedro Woolley WA PeaceHealth United General Hospital Sound Physicians of Emergency Medicine of Washington Out-of-Network
Prosser WA Prosser Memorial Hospital Prosser Memorial Hospital In-Network
Centralia WA Providence Centralia Hospital Northwest Emergency Physicians In-Network
Spokane WA Providence Holy Family Hospital Emergency Physician Services In-Network
Colville WA Providence Mount Carmel Hospital Providence Mount Carmel Hospital In-Network
Everett WA Providence Regional Medical Center Everett Colby Campus
North Sound Emergency Medicine In-Network
Spokane WA Providence Sacred Heart Medical Center and Children’s Hospital Spokane Emergency Physicians In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise Primary Network 9
City State Hospitals In-Network ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Chewelah WA Providence St. Joseph’s Hospital Providence St. Joseph’s Hospital In-Network
Walla Walla WA Providence St. Mary Medical Center Providence St. Mary Medical Center In-Network
Olympia WA Providence St. Peter Hospital Olympia Emergency Service In-Network
Pullman WA Pullman Regional Hospital Pullman Regional Hospital In-Network
Quincy WA Quincy Valley Hospital Quincy Valley Hospital In-Network
Moses Lake WA Samaritan Hospital Samaritan Hospital In-Network
Seattle WA Seattle Children's Hospital Seattle Children's Hospital In-Network
Toppenish WA SHC Medical Center Toppenish Olney Emergency Group In-Network
Spokane WA Shriners Hospital for Children ER services are not offered at this facility.
Mount Vernon WA Skagit Valley Hospital Northwest Emergency Physicians In-Network
White Salmon WA Skyline Hospital Skyline Hospital In-Network
Snoqualmie WA Snoqualmie Valley Hospital Snoqualmie Valley Hospital In-Network
Spokane WA Spokane VA Medical Center ER services are not offered at this facility.
Burien WA St. Anne Hospital Highline Emergency Physicians In-Network
Gig Harbor WA St. Anthony Hospital Northwest Emergency Physicians In-Network
Lakewood WA St. Clare Hospital Northwest Emergency Physicians In-Network
Enumclaw WA St Elizabeth Hospital Northwest Emergency Physicians In-Network
Federal Way WA St Francis Community Hospital Northwest Emergency Physicians In-Network
Longview WA St. John Medical Center St. John’s Emergency Physicians In-Network
Tacoma WA St Joseph Medical Center Northwest Emergency Physicians In-Network
Elma WA Summit Pacific Medical Center Summit Pacific Medical Center In-Network
Sunnyside WA Sunnyside Community Hospital Sunnyside Emergency Group In-Network
Edmonds WA Swedish Edmonds California Emergency Physicians In-Network
Seattle WA Swedish Medical Center Ballard Ballard Emergency Physicians In-Network
Seattle WA Swedish Medical Center Cherry Hill Seattle Emergency Physicians In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise Primary Network 10
City State Hospitals In-Network ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Seattle WA Swedish Medical Center First Hill Seattle Emergency Physicians In-Network
Issaquah WA Swedish Medical Center Issaquah Eastside Emergency Physicians In-Network
Mill Creek WA Swedish Mill Creek Campus (Free-standing Emergency Room)
Eastside Emergency Physicians In-Network
Redmond WA Swedish Redmond Campus (Free-standing Emergency Room)
Eastside Emergency Physicians In-Network
Brewster WA Three Rivers Hospital Three Rivers Hospital In-Network
Clarkston WA Tri-State Memorial Hospital Tri-State Memorial Hospital In-Network
Tacoma WA VA Puget Sound Health Care Services - American Lake Division
ER services are not offered at this facility.
Seattle WA VA Puget Sound Health Care System - Seattle ER services are not offered at this facility.
Yakima WA Virginia Mason Memorial Hospital Virginia Mason Memorial Hospital In-Network
Wenatchee WA Wenatchee Valley Hospital Wenatchee Valley Hospital In-Network
Coupeville WA WhidbeyHealth Medical Center WhidbeyHealth Medical Center In-Network
Colfax WA Whitman Hospital and Medical Center Whitman Hospital and Medical Center In-Network
South Bend WA Willapa Harbor Hospital Willapa Harbor Hospital In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise Alpine Network 11
Section 3: LifeWise Alpine Network
City State Hospitals In-Network ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Wenatchee WA Central Washington Hospital Central Washington Hospital In-Network
Ephrata WA Columbia Basin Hospital Beezley Springs Inpatient Services In-Network
Astoria OR Columbia Memorial Hospital Oregon Health & Science University (OHSU) Out-of-Network
Grand Coulee WA Coulee Medical Center Coulee Medical Center In-Network
Dayton WA Dayton General Hospital Dayton General Hospital In-Network
Ritzville WA East Adams Rural Hospital East Adams Rural Hospital In-Network
Republic WA Ferry County Memorial Hospital Ferry County Memorial Hospital In-Network
Pomeroy WA Garfield County Memorial Hospital Garfield County Memorial Hospital In-Network
Aberdeen WA Grays Harbor Community Hospital Northwest Emergency Physicians In-Network
Moscow ID Gritman Medical Center Gritman Medical Center In-Network
Seattle WA Harborview Medical Center Emergency Department at Harborview In-Network
Port Townsend WA Jefferson Healthcare Hospital Jefferson Healthcare Hospital In-Network
Walla Walla WA Jonathan M Wainwright Memorial VA Medical Center ER services are not offered at this facility.
Goldendale WA Klickitat Valley Hospital Klickitat Valley Hospital In-Network
Chelan WA Lake Chelan Community Hospital Lake Chelan Community Hospital In-Network
Davenport WA Lincoln Hospital Lincoln Hospital In-Network
Pasco WA Lourdes Medical Center Northwest Emergency Physicians In-Network
Shelton WA Mason General Hospital Mason General Hospital In-Network
Omak WA Mid Valley Hospital Mid Valley Hospital In-Network
Morton WA Morton General Hospital Morton General Hospital In-Network
Newport WA Newport Community Hospital Newport Community Hospital In-Network
Ilwaco WA Ocean Beach Hospital Ocean Beach Hospital In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (03-04-2021) LifeWise Alpine Network 12
City State Hospitals In-Network ER Physician Group Servicing the Hospital ER Physician Group
Network Status
Odessa WA Odessa Memorial Healthcare Center Odessa Memorial Healthcare Center In-Network
Port Angeles WA Olympic Medical Center Olympic Medical Center In-Network
Othello WA Othello Community Hospital Othello Community Hospital In-Network
Prosser WA Prosser Memorial Hospital Prosser Memorial Hospital In-Network
Pullman WA Pullman Regional Hospital Pullman Regional Hospital In-Network
Moses Lake WA Samaritan Hospital Samaritan Hospital In-Network
Seattle WA Seattle Children’s Hospital Seattle Children’s Hospital In-Network
Spokane WA Shriners Hospital for Children ER services are not offered at this facility.
White Salmon WA Skyline Hospital Skyline Hospital In-Network
Sunnyside WA Sunnyside Community Hospital Sunnyside Emergency Group In-Network
Clarkston WA Tri-State Memorial Hospital Tri-State Memorial Hospital In-Network
Kennewick WA Trios Southridge Hospital Columbia Valley Emergency Physicians In-Network
Tacoma WA VA Puget Sound Health Care Services - American Lake Division
ER services are not offered at this facility.
Seattle WA VA Puget Sound Health Care System - Seattle ER services are not offered at this facility.
Yakima WA Virginia Mason Memorial Hospital Virginia Mason Memorial Hospital In-Network
Wenatchee WA Wenatchee Valley Hospital Wenatchee Valley Hospital In-Network
Colfax WA Whitman Hospital and Medical Center Whitman Hospital and Medical Center In-Network
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Emergency Room Provider Directory
LifeWise Health Plan of Washington Member Plans Last updated March 4, 2021
LifeWise Health Plan of Washington
019322 (11-01-2020) 13
Disclaimer: LifeWise makes reasonable efforts to validate that the list of providers displayed is up to date and accurate. If possible, please verify with the hospital or the physician that they continue to be a member of the network. A provider listing in the locator website is not an indication that the provider’s services are eligible for benefits. Please consult your summary plan description, contact customer service at 800-592-6804, or have the provider submit a benefit advisory to determine available benefits.
Important note: Providers in our network may have more than one medical group affiliation, so a provider’s network participation can vary depending upon where he/she is providing services. Be sure to confirm the provider's network participation at the location you plan to visit. Also note, not all members have out-of-area coverage. Please call customer service or check your benefit summary plan to verify. Balance Billing Protection Act: The Washington state legislature passed the Balance Billing Protection Act in 2019 which prohibits balance billing for emergency services provided by non-contracted providers in Washington, Oregon, and Idaho. This act also prohibits balance billing for covered surgical or ancillary services provided by a non-contracted provider in an in-network facility in Washington. The act is effective January 1, 2020 and applies to Premera members covered under fully-insured plans and self-funded plans that choose to participate.
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051267 (11-20-2019)
Discrimination is Against the Law
LifeWise Health Plan of Washington (LifeWise) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. LifeWise does not exclude people or treat them differently because of race, color, national origin, age, disability, sex, gender identity, or sexual orientation. LifeWise provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats, other formats). LifeWise provides free language services to people whose primary language is not English, such as qualified interpreters and information written in other languages. If you need these services, contact the Civil Rights Coordinator. If you believe that LifeWise has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Civil Rights Coordinator ─ Complaints and Appeals, PO Box 91102, Seattle, WA 98111, Toll free: 855-332-6396, Fax: 425-918-5592, TTY: 711, Email [email protected]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Ave SW, Room 509F, HHH Building, Washington, D.C. 20201, 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
Language Assistance ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 800-817-3056 (TTY: 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 800-817-3056(TTY:711)。 CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 800-817-3056 (TTY: 711). 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 800-817-3056
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Tumawag sa 800-817-3056 (TTY: 711). УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби
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គឺ�ច�នសំ�ប់បំេរ �អ�ក។ ចូរ ទូរស័ព� 800-817-3056 (TTY: 711)។ 注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。800-817-3056(TTY:711)
まで、お電話にてご連絡ください。 ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ
800-817-3056 (መስማት ለተሳናቸው: 711). XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 800-817-3056 (TTY: 711).
.)711: والبكم الصم ھاتف رقم( 800-178-3056 برقم اتصل. بالمجان لك تتوافر اللغویة المساعدة خدمات فإن اللغة، اذكر تتحدث كنت إذا: ملحوظةਿਧਆਨ ਿਦਓ: ਜੇ ਤੁਸ� ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ, ਤ� ਭਾਸ਼ਾ ਿਵੱਚ ਸਹਾਇਤਾ ਸਵੇਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ। 800-817-3056
(TTY: 711) 'ਤੇ ਕਾਲ ਕਰੋ। ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.
Rufnummer: 800-817-3056 (TTY: 711). ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ,
ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 800-817-3056 (TTY: 711). ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 800-817-3056 (TTY: 711). ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 800-817-3056 (ATS : 711). UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 800-817-3056 (TTY: 711). ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 800-817-3056 (TTY: 711). ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero
800-817-3056 (TTY: 711). .دیریبگ تماس TTY: 711) 3056-817-800) با. باشد یم فراھم شما یبرا گانیرا بصورت یزبان التیتسھ د،یکن یم گفتگو فارسی زبان بھ اگر: توجھ