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Medicaid Management Information System (MMIS) Re-Procurement Project DSHS, Washington State Department of Social and Health Services

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Note: To access ProviderOne your organization must provide you access by completing the steps outlined on our Security page.

 


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ProviderOne LogoProviderOne Registration Activity

To minimize effort for providers and staff, DSHS moved existing provider records from the old Medicaid payment system to ProviderOne.  This allows providers and DSHS to avoid a full-scale re-enrollment and credentialing effort.

The most urgent readiness task for providers is to register in ProviderOne.  Registration includes reviewing and validating that your provider file has been set up properly and telling DSHS how you plan to submit transactions.


Registering in ProviderOne is free.  Not registering could be costly.

Completing the registration process benefits providers by allowing you to:

  • Verify addresses where payments will go.

  • Review performing providers associated with your organization.

  • Report missing data, such as National Provider Identifiers, that could affect payments.

  • Indicate how you plan to bill DSHS so we know if you will need a Trading Partner Agreement.

  • Learn the DSHS taxonomies associated with your organization. You will need these for billing.

  • Make sure your license information is up to date.

  • Make any corrections to your provider file before we go live.

  • Avoid a full-scale re-enrollment and credentialing effort.

 

When should I complete my registration?

All providers should begin registration activities now.  Providers who will use Health Insurance Portability and Accountability Act (HIPAA) batch file transactions must complete registration and testing before ProviderOne is implemented to be payable in the new system. 

DSHS strongly urges all other providers to register to minimize the risk that claims will process incorrectly or that payment is sent to the wrong address or Electronic Funds Transfer account.

New!
Ten Common Problems Providers Face in the Registration Process
Please read this tip sheet for some answer to some common problems.

Registration activities depend on the type of transactions you will conduct with ProviderOne and the type of provider you are

Provider readiness activities for Phase 1 implementation depend on the type of provider you are and how you plan to submit transactions to us. 

 

 

Transaction type: 

  Activity:

Pharmacy POS

Direct Entry Website

Paper

Use Billing Agent or Clearinghouse

HIPAA Batch File

WINASAP

 1.

Security

 2.

Registration 
select your transaction type

√ 

3.

New Client ID Requirements 

 4.

New Taxonomy Requirements 

 *Non-typical claims not billed through POS like DME

 5.

Trading Partner Agreement  

 

 

 

  *√
 * If you self-submit HIPAA transactions -837, 835, 270/271, etc.

 6.

Test

 

 

 

 *√

√ 

Please select the appropriate link below that describes how you will submit transactions to ProviderOne when it's implemented to begin.  You will be guided through the appropriate steps for security and registration activities

If you are a performing (servicing) provider, you do not need to register.  You will be registered by the organization you work for.

Tribal Health Clinics should select the transaction type above that describes how you plan to submit transactions to ProviderOne.


A Few Key Areas to Confirm During Registration that could Affect Payments:

  • Check your "pay to" address.  This is where your payment will be sent if you don't have Electronic Funds Transfer (EFT) set up.

  • Verify your NPI is reported and correct.

  • Know the taxonomies and who they are associated to in your organization.  These must be appropriately indicated while billing or your claims will deny (does not apply to pharmacy POS transactions).

  • Check that your business license information is entered and up to date.

  • Indicated how you plan to bill us and review your payment details.  This is important if you plan on using HIPAA batch file transactions so we can ensure you have a new Trading Partner Agreement.


If you have questions, please:

It’s important to us that you have access to staff who can answer your questions about ProviderOne.  However, we want you to know that we are experiencing a high volume of contacts and are currently reallocating and training additional staff to assist you.  For the quickest response, we suggest you use email when possible and include key information in the subject line.

Join the provider readiness email distribution list!

The ProviderOne project has established an email distribution list dedicated to provider readiness activities.

Please pass this link on to providers or anyone that may be interested in receiving updates on provider readiness activities for ProviderOne. You may join or leave this list anytime at: 

http://listserv.wa.gov/archives/providerone_provider_readiness.html

 

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