Coordination of Benefits

Information for Insurance Companies

Have you received a Computerized Insurance Invoice? You've received this invoice from Washington State Medicaid, Department of Social and Health Services, Coordination of Benefits Section. Our office has been notified that a Medicaid recipient has private health insurance with your company. We have sent you this invoice to see if the Department should be reimbursed by your company for medical claims that we have already paid. If you have questions about this invoice, please Contact Us! or call us at

If you need to refund us, please mail your remittance check to:

Department of Social and Health Services
Financial Recovery Unit-Med
PO Box 45862
Olympia, WA 98504-5862

Mail inquiries regarding this form can be sent to:

Department of Social and Health Services
Health Insurance Recovery Unit
PO Box 45565
Olympia, WA 98504-5565