ProviderOne

Client Advocates

Frequently Asked Questions (FAQs)

Last Updated 10/15/09

Can community-based organizations who are not providers – but work with DSHS clients in determining their eligibility, help with recertification, scheduling appointments, finding providers, etc. – have the same access that providers have to client information, such as end dates and recertification dates?

One advocate suggested that client advocate agencies get information that a client could give to their provider who may not recognize the new Services Card. A scenario was imagined where a client took the new card to a small provider who refused the client services because they were not familiar with the new card. What could the advocate give to the client to take back to the provider that would explain the new card and a short description of how to use the card?

Q: Can community-based organizations who are not providers – but work with DSHS clients in determining their eligibility, help with recertification, scheduling appointments, finding providers, etc. – have the same access that providers have to client information, such as end dates and recertification dates?

A: DSHS has a responsibility to protect Personal Health Information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA). Advocates and organizations with a client’s permission are encouraged to listen to eligibility information with their client through our Interactive Voice Response (IVR) telephone system. The IVR will access the same eligibility information providers have access to through ProviderOne.

Q: One advocate suggested that client advocate agencies get information that a client could give to their provider who may not recognize the new Services Card. A scenario was imagined where a client took the new card to a small provider who refused the client services because they were not familiar with the new card. What could the advocate give to the client to take back to the provider that would explain the new card and a short description of how to use the card?

A: In addition to the materials developed for clients, there are several ProviderOne materials developed to help providers understand how to use the Services Card and how to check eligibility in the absence of the Services Card – just as they can do with the Medical Assistance ID (MAID) today. These can be printed off of the provider fact sheet page on our Web site http://hrsa.dshs.wa.gov/providerone/Providers/Fact%20Sheets/FactSheets.htm We suggest Options for Verifying Client Eligibility. You may also find Client Services Card Will Replace MAID, DSHS is Changing to a New Client Identifier, and Optional Magnetic Card Reader useful.