News and Highlights

Inpatient Admission Form Not Available

If you need to send an inpatient notification to Group Health, please send it via our secure fax number: 206-901-6109.

Annual NCQA Notification

Providers were recently emailed a postcard about updates to our guidelines and other important information. We encourage you to review these updates at your earliest convenience.

2015 Practitioner Satisfaction Survey

If you received a survey invitation letter from Group Health, please complete the 2015 Practitioner Satisfaction Survey before Oct. 31, and share your opinions about our utilization management process.

Provider Update: September 2015 (PDF)

ICD-10 implementation; updated asthma, diabetes, and chlamydia guidelines; pharmacy updates, and more.

Formulary Decision Highlights: September 2015 (PDF)

Highlights from the Sept. 9 meeting.

Prior Authorization for Office-Administered Injectable Drugs

Non-Medicare Drug List updated Sept. 29, 2015.

Colorectal Cancer Screening CME Course (PDF)

Group Health is offering a free online CME course on Wednesday, Oct. 7 from 7-8 a.m. or 1-2 p.m. For details, e-mail

ICD-10 Authorizations

Our system accepts prior authorization requests with ICD-10 codes. For information on how to submit requests, see ICD-10 FAQs.

Care Management Internalizing Health Dialog Services

Group Health no longer contracts with Health Dialog, a vendor providing health coaching services. These services are now part of Care Management.

Review Services Updates: September 2015 (PDF)

Procedure notifications, updates to Transition of Care policy, ICD-10 information, and more.

August Clinical Tips

Check out Clinical Pearls — recommendations you can integrate into your daily practice.

Changes to Medical Necessity Review Criteria (PDF)

Effective Nov. 1, changes to medical necessity review criteria may affect coverage of services for intensity modulated radiation therapy (IMRT) and implantable loop recorder (cardiac event recorder).

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ICD 10ICD-10: Oct. 1, 2015

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ICD-10 Implementation

Notify Us of a Change to Your Practice

Complete the appropriate form and e-mail it to Provider Services.

Contracted Provider Information Change/Update Form (Word)

Non-Contracted Provider Information Change/Update Form (Word)

Provider Manual

Contractually binding information on this site.
Provider Manual Index

Clinical Guidelines

Recommendations for clinicians and patients.
Clinical Guidelines