ProviderOne is an online, electronic payment and claims processing system that replaces the Social Service Payment System (SSPS). As of January, 2015 providers of social and medical services to Washington residents must use ProviderOne to bill for Medicaid services and receive payment. (Note: Individual Providers will start using the new payment system in early 2016.)
Below are some resources to help you with ProviderOne.
If your payment was not processed the way you expected, review the ProviderOne Discovery Log. It is updated regularly with information about system issues, including the number of affected providers, and steps you can take to resolve the issue.
- Providers: Get Ready Now
Learn what it takes to prepare to use the new payment system in late 2014.
- National Provider Identifier
Medical providers must take additional steps to transition from the old SSPS payment. system to the online, electronic billing system.
- Background on ProviderOne
Changing from a 30-year-old-phone and paper-billing system to an electronic system will offer convenience in managing your Medicaid claims.
- Who is Transitioning to ProviderOne?
See examples of social service and medical providers.
- Information for Individual Providers
Providers of personal care and respite services who receive a W2 tax form are not transitioning to ProviderOne but to a new payment system.
Current Shared Services Supplemental Billing Guide
The billing guides below will assist Medical Social Service providers to properly bill for shared services provided to eligible clients. These supplemental billing guides are available for download on the following Health Care Authority provider guide webpages:
- Complex Rehabilitation Technology
- Durable Medical Equipment (Other) and Non-CRT Wheelchairs
- Home Health Services (Acute Care Services)
- Medical Nutrition Therapy
- Nondurable Medical Supplies & Equipment (MSE)
- Outpatient Rehabilitation
- Private Duty Nursing For Children
- Prosthetic & Orthotic Devices
- Respiratory Care
Social Service Batch Upload
Social service batch upload billing is an optional billing method to allow providers to extract billing data elements from their current timekeeping and/or billing software and upload the claim(s) data into the ProviderOne system. Although batch upload does require additional preparation, your agency could save time and effort with this option.
NOTE: This billing option should not be confused with template batch billing.
The batch upload billing method is suitable for large providers and/or providers who are required to bill by date of service such as home care agencies, adult day care centers, large residential facilities, home delivered meals programs, and personal emergency response systems.
For additional questions regarding the setup of social service batch upload billing:
ProviderOne Health Care Authority
- Christmas and New Year's holiday will impact ProviderOne claims submission deadline 2020
- COVID Enhanced Rate and Retainer Payment Webinar for Residential Providers (this is a repeat presentation)
- COVID Enhanced Rate Webinar
- COVID Retainer Payments Webinar for Adult Day Providers
- Social Service ProviderOne Portal Changes Webinar
- Amended HCS Management Bulletins related to pandemic service codes and rates
- Veterans Day holiday will impact ProviderOne claims submission deadline (2020)
- Thanksgiving holiday will impact ProviderOne claims submission deadline (2020)