Washington: Start Here
Beginner guide for Washington—Healthplanfinder, OIC IRO review, RCW 48.43.830 PA & appeals.
Read guideState playbook
Washington
State insurers, legislation, and appeal resources for patients and advocates in Washington.
4 guides
Washington Prior Authorization Law
RCW 48.43.830—3-day ePA / 5-day standard; HB 1357 timelines; WSMA navigator.
Read guideWashington Health Insurance Appeals and Grievances
RCW 48.43.530 grievance, 180-day filing, deemed exhaustion, path to IRO.
Read guideWashington Independent Review (OIC / IRO)
Free binding review—120 days to file, 15–20-day standard / 72-hour expedited.
Read guidePrior auth & internal appeals
Match the plan on the member ID card. Use the denial letter for where to file appeals.
- Premera Blue Cross
- Regence BlueShield
- Kaiser Permanente Washington
- LifeWise Health Plan of Washington
- Community Health Plan of Washington
- Molina Healthcare of Washington
- Washington Healthplanfinder
- WSMA Prior Authorization Navigator
- Apple Health (Medicaid MCOs)
External appeals
After internal appeal, for eligible Washington fully insured plans only.
- OIC — certified independent review
- Apple Health — administrative hearing