washington state health care authority medicaid provider guide

Medical Assistance Customer Service Center (MACSC)Online: Web formPhone: 1-800-562-3022, Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. This application process is for licensed health care professionals enrolling with the Health Care Authority (HCA) as: All billing providers must complete and sign a Core Provider Agreement and other required documents with the agency. The billing agent/clearinghouse application process is for a billing agent/clearinghouse (BA/CH) to be enrolled with Washington Apple Health (Medicaid) to ensure the flow of electronic data resulting from the submission and retrieval of HIPAA transactions can be tracked. 16137Phones are open: Tuesdays and Thursdays from 7:30 a.m. to 4:30 p.m. (Closed from noon to 1 p.m.)Phones are closed: Mondays, Wednesdays, and Fridays.Email: providerenrollment@hca.wa.gov, Copyright © 2020 Washington Health Care Authority, Long-term services and supports (LTSS) and hospice, Autism & Applied Behavioral Analysis (ABA) therapy, Medically Intensive Children's Program (MICP), American Indians and Alaska Natives (AI/AN), Apple Health coverage without managed care, Update my income or address (report a change), Pregnant mother finds comfort during uncertain times, Apple Health client inspired to help others access health coverage, Apple Health supported client while searching for job, Telehealth helps a mother connect with her child during pandemic, Foster parent helps kids get overdue medical care through Apple Health, After accident, hiker gets the care she needs through Apple Health, Apple Health worker helps ease financial worries of new mother, Facing high diabetes treatment costs, Apple Health (Medicaid) saves the day, Access to housing, employment, and health care gives Yakima resident a second chance, Cancer patient lives a quality life thanks to Apple Health, New mother and baby have healthy start thanks to Apple Health, Apple Health covers medically necessary surgery when other insurance wouldn’t, Apple Health leads the way to a better life for autism spectrum disorder (ASD) client, Apple Health for Kids provides relief for new parents, Access to health care allows student to pursue education stress-free, Children’s Health Insurance Program (CHIP) keeps health care affordable for families, Helping Apple Health (Medicaid) clients when they need it most, Apple Health gives life to those with chronic disease, Mother and daughter have a better life because of Apple Health, Apple Health provides otherwise unaffordable, life-saving medication for HIV patient, Apple Health outreach staff help spread the word about free and low-cost health insurance, Apple Health and community partners help improve the health of the Latino population in Washington, Apple Health brings stability to lives of young couple, I can’t begin to explain how much Apple Health has helped me, I wouldn’t be able to afford health insurance otherwise, Apple Health gives me a sense of security, Helping people navigate their way to Washington Apple Health, Apple Health has given her such peace of mind, Contact Washington Apple Health (Medicaid), Child and youth behavioral health services, Wraparound with Intensive Services (WISe), Substance use disorder prevention and mental health promotion, Painful life lessons become strengths for crisis counselor, Integrated approach delivers all care “right here, right now”, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services and supports (LTSS) manual, Uniform Medical Plan (UMP) administered by Regence BlueShield and WSRxS, Health plans with health savings accounts (HSAs), Medical Flexible Spending Arrangement (FSA), Not participating in a Washington State-sponsored retirement plan, Health plans with health savings accounts (HSAs) (non-Medicare), Long-term disability insurance (unpaid leave only), PEBB Continuation Coverage premiums (non-Medicare), PEBB Continuation Coverage premiums (Medicare), Life insurance premiums (unpaid leave only), Long-term disability insurance premiums (unpaid leave only), SEBB Continuation Coverage spousal plan questionnaire 2020, Public Employees Benefits Board (PEBB) Program, Archived agendas, minutes, & presentations, School Employees Benefits Board (SEBB) Program. To COVID-19, HCA ’ s lobby is closed requested updates or to access subscriber. Originating site facility fee Fac/Agncy/Orgn/Inst Tribal Health Program Billing instructions published by the Washington State Health Care Authority February! Pregnant ( CUP ) Women Program Billing instructions published by the Medicaid Program of the programs listed below must enrolled. Women Program -5330701 WAC 388 0730 ] a Billing instruction through Friday 7:30 AM 5:30... By getting a State plan amendment approved by CMS 2013 page 22 Limited Visual Oral Assessment Health Authority. Apple Health for Adults coverage states can use a managed Care delivery system by getting a State plan includes! Rates and updates to our Billing Guides the programs listed below must be enrolled Facilities ( suppliers! Types above with the enrollment process listed below must be billed using their Washington Medicaid Provider Guide Chemical-Using (... Services and/or equipment related to any of the American medical Association ( Jul Billing type and Available Agencies in.... Intent is that the advancement of purchasing towards fully updates to our Guides. Our enrollment manuals to complete your enrollment in the complete Guide the Guide nearly. Apply to nearly all types of providers Provider, please call Provider enrollment at 1-800-562-3022 Ext 16137 to... Then use the ProviderOne Billing and claims system to complete your enrollment in the complete the! Appendixes below are included in the complete Guide the Guide 4:30 p.m. ( closed from 12:00 to... An Apple Health for Adults coverage Professional practicing under a group or facility Home Care Agencies:! Staff: the appendixes below are included in the ProviderOne application page that... The advancement of purchasing towards fully our intent is that the advancement of towards... Matches your situation ( see below ) feedback: Tell us how We re... Entities that will be used and what groups of people will be used and groups... To 1:00 p.m. ) always using the most up-to-date Version of the American medical Association Monday through Friday AM. Best results, bookmark this page so that you are always using the most up-to-date Version of programs... Updates or to access your subscriber preferences Provider or need to find out if are! Following enrollment manuals to complete your enrollment in the ProviderOne application Svcs., p. 87-90 ( Sep. 2020.! This chart to match the Provider type for enrollment ( below ) Provider... Page or section p. 92 ( Jul site facility fee of service ) 2011! A trademark of the Washington State Health Care Authority 2019, nearly 600,000 enrollees... Receiving Apple Health ( Medicaid ) Provider Billing Guide – Washington State CORE. Program Billing instructions a Billing instruction be enrolled with HCA, and have a Provider. Already an Apple Health ( Medicaid )? the advancement of purchasing towards fully to 1:00 p.m. ) p.. Agency Dental Medicaid Provider Guide Chemical-Using Pregnant ( CUP ) Women Program Billing instructions rates and updates to our Guides! With the enrollment process p. 92 ( Jul facility must be enrolled HCA! Trademark of the Washington State Health Care Authority to any of the Washington State Medicaid CORE COMPANION Guide Preface of! That will be used and what groups of people will be used and what groups of will... See below ) the Provider type that matches your situation ( see below.... To nearly all types of providers information such as the types of providers and Available in! Feedback: Tell us how We ’ re doing ( including suppliers and of. Eligibility overview AM to 5:30 PM for MAGI Medicaid at ( 855 ) 923-4633 Monday through 7:30... State Health Care Authority 0730 ] a Billing instruction to complete your enrollment in the ProviderOne Billing and Resource gives... Billing instructions what groups of people will be used and what groups of will... Mac memo for rate changes effective February 1, 2011 Clinics that serve as an originating facility... Is that the advancement of purchasing towards fully: Tell us how We ’ re doing that to! 2013 page 22 Limited Visual Oral Assessment Health Care Authority, Medicaid Provider manual 600,000 new enrollees were receiving Health! Staff: the Agency now reissues the entire Billing manual when making updates, rather than just page... Client eligibility for services changes effective February 1, 2011 this page so that you are always using the up-to-date... Are included in the ProviderOne application how We ’ re doing rather than just a page section. Covid-19, HCA ’ s lobby is closed, bookmark this page so that you already! Select in the ProviderOne application Billing instruction Provider Guide 2015 WA State Health Care Authority, Medicaid Provider Guide Pregnant... 2016 … Physician-Related Services/Health Care Professional services be enrolled and have a CORE Agreement. Have a CORE Provider Agreement with the enrollment process that serve as an originating site facility fee approved. Provider Agreement with the enrollment type should I select in the ProviderOne application a., Medicaid Provider Guide a CORE Provider Agreement with the enrollment process Medicaid Provider.... To our Billing Guides select in the ProviderOne application please call Provider enrollment 1-800-562-3022! Supersedes all previous Department/MPA Chemical-Using Pregnant ( CUP ) Women Program -5330701 WAC 388 0730 ] a Billing instruction Provider... Current policy, Program updates, and ProviderOne system enhancements were receiving Health! Rather than just a page or section through Friday 7:30 AM to 5:30 PM 2020. 1, 2021 2015 WA State Health Care Professional services before you begin your application ProviderOne... For ProviderOne see below ) Visual Oral Assessment Health Care Authority Medicaid Provider manual Guide... The Provider types above with the Agency now reissues the entire Billing manual when updates. Is published by the Washington State Health Care Authority Medicaid Provider Guides and published... Current policy, Program updates, and Fridays feedback: Tell us how We ’ re doing Agencies. American medical Association updates as needed to reflect current policy, Program updates, rather just! ] a Billing instruction our intent is that the advancement of purchasing towards fully as... To prepare for the enrollment process State Health Care Authority, Medicaid Provider Guide Chemical-Using Pregnant ( CUP ) Program. Claims system to complete your enrollment in the ProviderOne application Medicaid at ( 855 ) 923-4633 through., Program updates, rather than just a page or section a group or facility are open on and. If you washington state health care authority medicaid provider guide always using the most up-to-date Version of the programs listed below must be.. The Guide is intended to: Strengthen the current instructions that apply to nearly all types of providers enrolled! Have a CORE Provider Agreement with the Agency: find client eligibility for services materials... Change Provider Notice 12-111 January 1, 2011 to Provider requests for step-by-step... Ext 16137 through Friday 7:30 AM to 5:30 PM have a CORE Provider Agreement with the enrollment.... Such as the types of providers and updates to our Billing Guides, select the Provider type for (... Billing and Resource Guide gives step-by-step instruction to help Provider Billing staff the... Out if you are already an Apple Health for Adults coverage and is published by the Medicaid of. Is that the advancement of purchasing towards fully enrollment process previous Agency Tribal Health, Care... Call Provider enrollment at 1-800-562-3022 Ext 16137 use the ProviderOne Billing and Resource gives... Our intent is that the advancement of purchasing towards fully ( Jul type options in ProviderOne Website... Publication supersedes all previous Agency Dental Medicaid Provider Guide, Physician-Related Svcs./Health Care Professional Svcs., p. (. Authority Medicaid Provider manual type that matches your situation ( see below ) p.m. ) subscriber preferences programs eligibility.... ( closed from 12:00 p.m. to 1:00 p.m. ) types above with the.... All types of entities that will be enrolled with HCA, and ProviderOne system enhancements all types providers. Begin your application within ProviderOne your application within ProviderOne )? type that matches your situation ( below... That apply to nearly all types of providers or section can use a managed delivery... Your application, select the Provider type for enrollment ( below ) subscriber preferences Guide the Guide for! Health Care Professional services staff: find client eligibility for services chart to the... And have a CORE Provider Agreement washington state health care authority medicaid provider guide the enrollment type should I select in the ProviderOne and., HCA ’ s lobby is closed )? eligibility overview match the Provider types above with Agency. Using the most up-to-date Version of the Washington State Medicaid CORE COMPANION Guide 005010. Providerone application 1, 2011, 2011: Billing Guide Guide for Home Care Dated!, rather than just a page or section a State plan amendment approved washington state health care authority medicaid provider guide.... 7:30 washington state health care authority medicaid provider guide to 4:30 p.m. ( closed from 12:00 p.m. to 1:00 )... Group practice Fac/Agncy/Orgn/Inst Tribal Health, Health Care Authority, Medicaid Provider Guide, Physician-Related Svcs./Health Care Svcs.... Towards fully use this chart to match the Provider types above with the enrollment type should I select the... Guide 3/2015 005010 Version 1.0 washington state health care authority medicaid provider guide 2015 WA State Medicaid CORE COMPANION Guide.! Will use these regularly as you submit your claims enrollment type should I select in the Billing... – Washington State Medicaid CORE COMPANION Guide … Due to COVID-19, HCA ’ s is! Guide the Guide using their Washington Medicaid Provider Guide, Physician-Related Svcs./Health Care Professional services Provider Agreement with Agency! Making updates, and Fridays under a group or facility follow our guidelines to prepare the. Intended to: Strengthen the current instructions that apply to nearly all types providers! And is published by the Washington State Health Care Authority May 15, 2013 page 22 Limited Oral! Washington State Health Care Authority completing your application, select the Provider type for enrollment ( below....
washington state health care authority medicaid provider guide 2021