What is ProviderOne?

The Washington State Department of Social and Health Services (DSHS) is replacing its' current Medicaid Management Information System with a new payment processing system we have named ProviderOne.  ProviderOne will be DSHS' primary provider payment processing 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 is being developed with unprecedented cross-administration support within DSHS - more than a thousand DSHS employees have participated in discussion on development and design.  The state teams are working with the project's contractor, CNSI, which is based in Rockville, Md.

Updates:

August 14, 2008 - Pharmacy Point of Sale: A new page on our website has been established for pharmacies preparing for our new point of sale system. Click here to visit the new page.

August 4, 2008 - Implementation date for medical and nursing home claims: We are not on target for a Dec. 2008 implementation.  Please click here to visit our  projected implementation dates page for important updates.

July 28, 2008 - DSHS issued this message to pharmacies today:  Change to ProviderOne Pharmacy Go Live Date

DSHS is getting ready to switch over to its new Pharmacy Point of Sale (POS) system.  The new system will be put into operation only when it is fully tested, DSHS staff are prepared, and the pharmacy readiness activities have been performed.

On June 18, 2008, DSHS sent the following message to pharmacies and prescribers through email, a faxed memo, and postcard:

"DSHS feels confident we can begin routing POS transactions through the new ProviderOne system on August 18, 2008.  If we encounter any problems during the system testing that require additional time to be resolved, this date would be adjusted and pharmacies notified."

Click here to read the entire DSHS Numbered Memo 08-12 to pharmacies about implementing the new POS.

DSHS did identify problems during the testing process.  Corrections are being made and the system is being retested to ensure accurate claims processing.

DSHS will reassess the 'go live' date over the next two weeks.  DSHS will notify providers of the new 'go live' date by sending a 30-day notice to pharmacies through numbered memo, email, and fax.

We appreciate your patience as we work to ensure that the system is fully ready to process your claims before we go live.

If you have any questions, please email us at providerone@dshs.wa.gov or call us at 1-800-562-3022 (select option 2, then 4).

• A checklist to help pharmacies prepare for the new POS can be read by clicking here.

July 24, 2008

The first set of questions and answers from recent workshops on client eligibility are now posted on our provider Q&A page.  Click here to access the Spring 2008 Client Eligibility Volume 1 questions and answers.

 June 18, 2008

• Dear Providers,
  We have finished the latest series of provider readiness workshops on client eligibility.  Twenty-three sessions were held around the state, with more than 2,200 in attendance! 
  
  You can read the material presented at the workshops by clicking on one of these formats (please note this is a large file, 62 pages):

  • PowerPoint Format (7.88 MB)

  • PDF Format (1.52 MB)

  Two months before ProviderOne goes live, DSHS will host state-wide training demonstrations of ProviderOne. 

  If you have questions or feedback, please:
  - Email us at providerone@dshs.wa.gov  or
  - Call us at 1-800-562-3022 (select option 2, then option 4).

May 29, 2008

• A new issue of the ProviderOne Countdown is available. This newsletter is published to help prepare providers for ProviderOne.

Issue 3, May 2008 "Getting Proof of Eligibility"

• PDF Format

• Word Format

Click here to go to our newsletter page for all issues of ProviderOne Countdown.

Current Status of the ProviderOne Project