LifeWise Health Plan of Washington Partners

Healthcare benefit managers

Healthcare benefit managers (HCBMs) are required to register with the Washington State Office of the Insurance Commissioner (OIC). HCBMs are defined as persons or entities providing services to, or acting on behalf of, a health carrier that directly or indirectly impact the determination or use of benefits for, or patient access to, healthcare services, drugs, and supplies.

HCBMs include specialized benefit types such as pharmacy, radiology, laboratory, and mental health. HCBM services can also include but are not limited to prior- and pre-authorization of benefits or care; certification of benefits or care; medical necessity determinations; utilization review; benefit determinations; claims processing and repricing; outcome management; payment or authorization of payment to providers and facilities; dispute resolution, grievances, or appeals; provider network management, or disease management.

This registration requirement doesn’t affect member services. If members have questions, they can contact customer service at the phone number on the back of their ID card.

Who are LifeWise's healthcare benefit managers?