Managed Care Provider Information

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For Health Plans Patient Review and Coordination Guide This guide is for Managed Care Organizations in developing and managing a PRC Program. Enrollment Data This is where you can find Managed care statewide enrollment figures Encounter Data Reporting Instructions for health Plans to report encounter data RSN access to Care Standards Eligibility requirements for Authorization of Services for Medicaid Adults Contracted Health Plans The link above will take you to a page that lists all DSHS contracted health plans and contact information. ProviderOne Implementation Readiness FAQ's This link list answers to Frequently Asked Questions about ProviderOne Implementation

For All Providers 2009 Medical Benefits List of the most common benefits and how they are covered Primary care principles for Child Mental Health Intended to offer helpful guidance on the diagnostic and treatment process conducted by a primary care provider Billing Instructions and Rates These billing instructions and rates are for Fee for Service not for Managed care. To find billing instructions for the plans, please visit the plan web site page 2009 Managed Care Contracts These are the contracts that govern our health plans, ProviderOne The new DSHS Provider Payment System Children in Foster Care Information about foster care medical reimbursement

To provide care for Clients enrolled in Managed Care, Providers need to contract with the Health Plans.

For comments or questions

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Technical Site Comments: DSHS Webmaster.