Project Overview

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ProviderOne will be the Department of Social and Health Services (DSHS) primary provider payment system. When fully operational, it will pay about 100,000 providers who serve 1 million people who qualify for DSHS services each year. That’s about one out of every five Washingtonians.

ProviderOne will replace DSHS’ current 25-year-old Medicaid Management Information System (MMIS). Ultimately, ProviderOne will consolidate virtually all of the agency’s health-care and social service provider billings and payments. When fully operational, it will:

· Process 2 million claims a month for Medicaid, medical and similar social services payments

· Manage $4 billion per year in Medicaid, other federal and state-funded programs

When will ProviderOne be implemented?

Please see the current schedule.

Who is managing ProviderOne?

DSHS contracted with CNSI to develop the system and together manage the state project. More than 1000 DSHS staff have provided unprecedented cross-agency input to ensure the system meets the business needs with the least amount of interruption to providers and clients.

DSHS also contracted with Public Knowledge to assist providers, DSHS, and staff prepare for day-to-day business changes that will occur when ProviderOne is put into service.

Oversight on the project includes:

- Governor

- Information Services Board

- Centers for Medicaid and Medicare Services (CMS)

- DSHS Executive Steering Committee

- Sterling Associates, an independent quality and assurance firm that reviews project management controls and methodologies.

- SysTest, Inc. an independent verification and review vendor that reviews the technical system process.