Provider FAQ
- Can I verify eligibility information when the client does not bring their ID card with them at the time of service?
- A claim was denied, and I don’t understand why.
- Under Medicaid rules, my service is only allowed once every two years. How do I find out the last time this service was done for a particular client?
- How can I find out the meaning behind all the codes printed on the Medical Assistance ID card?
- Who needs to know when a client’s commercial insurance policy has ended?
- Is there an easy way to verify how much of a payment I have coming from DSHS?
Can I verify eligibility information when the client does not bring their ID card with them at the time of service?
- Yes. There are several ways to do this. If you have enrolled with our clearinghouse (ACS, at Web site https://wamedweb.acs-inc.com/wa/general/home.do ), you can use the WAMEDWEB site to search for eligibility. You can also use the Medical Eligibility Verification (MEV) systems that are offered by various contractors. If you are not enrolled in either of those options, call the toll-free Medical Assistance Customer Service Center (1-800-562-3022) and ask one of our provider specialists to help.
- Here’s how to check it. First, review your Remittance and Status report to check the denial code explanation. This should tell you what the problem was. If it’s still a mystery, review the billing instructions for program guidelines for your service specialty at Web site http://fortress.wa.gov/dshs/maa/Download/BI.html Still puzzled? Call the toll-free Customer Service Center at 1-800-562-3022 and have one of the specialists help track it down.
- First, identify the procedure code so we can be sure we’re talking about the right service. Then call the toll-free Customer Service Center at 1-800-562-3022 and have one of the specialists help. Incidentally, when our new payment system, ProviderOne, is put on line next year, it will have a screen that will let providers do this search by themselves.
How can I find out the meaning behind all the codes printed on the Medical Assistance ID card?
- You can find a detailed explanation of all the information located on the ID card by going to Section D of the “General Information” billing instructions. If you can’t find the reference you need, call our toll-free Customer Service Center 1-800-562-3022 and have one of the specialists help you track it down.
Who needs to know when a client’s commercial insurance policy has ended?
- Please contact our Coordination of Benefits Office directly at 1-800-562-6136.
Is there an easy way to verify how much of a payment I have coming from DSHS?
- The most up-to-date information is always available online at our WAMEDWEB site. If you aren’t enrolled, see the directions in Answer No. 1 above.) You also can follow the prompts on the automated features on our toll-free line (1-800-562-3022). The Interactive Voice Response system will also give you an accounting of what we owe you, although it may not always be as current as WAMEDWEB.
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