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.

Pharmacy News: July 2015 (PDF)

Asthma medication adherence, use of suvorexant, pharmacologic options for alcohol use disorder, and more.

Drugs Requiring Prior Authorization Approval

Effective Sept. 1, the following drugs require prior authorization:
Imiglucerase (Cerezyme), Taliglucerase Alfa (Elelyso), and Velaglucerase Alfa (VPRIV) (PDF)
Alemtuzumab (Lemtrada) (PDF)
Testosterone Cypionate, Testosterone Enanthate, and Testosterone Undeconoate (Aveed) (PDF)

Nivolumab, Pembrolizumab, and Ramucirumab Not Covered (PDF)

Effective Sept. 1, nivolumab (Opdivo), pembrolizumab (Keytruda), and ramucirumab (Cyramza) will not be covered.

Formulary Decision Highlights: June 2015 (PDF)

Highlights from the June 10 meeting.

Infliximab Prior Authorization Change (PDF)

Effective Aug. 1, the criteria for infliximab will include a change in prior authorization approval.

June Clinical Tips

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

Improved Process for Provider Reconsiderations on Its Way

Effective Aug. 3, Group Health's process is changing for requesting a provider reconsideration when there is disagreement on the final disposition of a claim.

Provider Update: June 2015 (PDF)

ICD-10 implementation, updated depression and tobacco use guidelines, new sleep disorders guideline, pharmacy updates, and more.

Group Health Contracted Hospitals (XLS)

List identifying whether contracted hospitals are religiously affiliated. For questions about services, contact the hospitals or Dr. Paul Sherman at Group Health.

'Ensuring Comprehensive Care at Religiously Affiliated Hospitals'

This member-approved advisory resolution reaffirm's Group Health's commitment to provide a full spectrum of legal, covered, and medically appropriate services, including reproductive health and end-of-life care.

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Provider Manual

Contractually binding information on this site.
Provider Manual Index

Clinical Guidelines

Recommendations for clinicians and patients about specific clinical circumstances.
Clinical Guidelines

Fraud, Waste, Abuse (FWA) Prevention Training

To complete Group Health's training, review our
Prevention of FWA Training slide show (PDF)