For Providers

We value our relationship with the professional provider community in Washington State and across the country. The information on this site should assist you with providing the best service to our participants and their families. Please contact us with questions or concerns.

On this page you can find out more about:

Eligibility
To determine whether a patient is currently eligible, please call the Trust Office. Please have the participant's member number available (Social Security numbers were discontinued as the primary ID in 2005). The member number can be found on the ID and Prescription Drug Card.

Carpenters Health and Security Plan of Western Washington
(206) 441-6514
8:00 AM - 5:00 PM PST

Preferred Provider Network
Our plan allows participants to visit any licensed provider covered by the plan. The plan uses the First Choice Health PPO Network. To verify if a specific provider is in the network, click here.
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Patient Copayments - Medical
For PPO providers, the plan has a $10 copayment for office visits, $50 for emergency room treatment, and $0 for hospital inpatient admissions. After the claim is adjudicated by the plan, the provider can bill the patient for any remaining allowable balance due to deductibles, copayments, coinsurance, or non-covered expense.

For non-PPO providers, the plan has a $20 copayment for office visits, $50 for emergency room treatment, and $200 for hospital inpatient admissions. Patient billing practice is subject to the provider's policy.

Dental Benefits
The dental benefit of the plan, administered by Delta Dental of Washington, covers 100% of the amount shown in the plan's Dental Fee Schedule. There is no deductible. The annual maximum per patient is $2,000.

Preauthorization is strongly recommended for any course of treatment costing $500 or more, and required for dental implants, hospitalization, or general anesthesia for routine dental services.

Contact Delta Dental of Washington for more information, including time limitations for procedures.

Medical Cost Containment Program
Cost containment consists of three elements:

  • Preadmission certification is mandatory for any scheduled inpatient hospital admission.
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  • Second surgical opinions are required (and paid for at 100%) for certain procedures.
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  • Case Management helps manage a variety of expensive or long-term forms of care.
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Claims Submission
Submit all claims to:

Carpenters Health and Security Trust of Western Washington
P.O. Box 1929
Seattle, WA 98111-1929

The plan will process the claim and provide the provider and participant with an Explanation of Benefits (EOB) describing what the plan paid, the PPO discount, if applicable, and what is owed as part of the annual deductible, copayment, coinsurance, and noncovered expenses.

Additional InformationClick on a link below for information on one of the listed topics

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