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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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Providers Using a Billing Agent or Clearinghouse

Registration Information

To minimize effort for providers and staff, DSHS moved existing provider records from the old Medicaid payment system to ProviderOne. Information on this page is specific to the registration activity for providers who use a billing agent or clearinghouse to submit transactions on their behalf.  If you are not a provider who uses a billing agent or clearinghouse, please click here to visit our Registration page.  Your registration activities may be different based on how you bill DSHS.

Billing Agents and Clearinghouses are third party entities - businesses - that submit information directly to DSHS Medical Assistance Program on behalf of an enrolled provider.

New! Oct 5, 2009 - Testing Status of Billing Agents and Clearinghouses
If you use one of these businesses to bill Medicaid claims for you, it is important for you to know if they have successfully tested HIPAA batch transactions.  To be ready to submit your transactions the first day ProviderOne is operational - Dec. 6, 2009 - they must successfully complete HIPAA batch transaction testing by Nov. 20, 2009The HIPAA test environment will be unavailable from Nov. 20 to Dec. 6 while we transition to the new system.  Organizations can resume testing after Dec. 6.
Click here to see billing agent and clearinghouse testing status

Note to new providers: if you applied to become a DSHS provider on or after July 25, 2008, you do not need to register (validate your organization's information) in ProviderOne.  You will need to complete the other applicable activities.

  Prepare for Registration                                       

Step 1

Security Administrator obtains log on and password

WHO:  Your staff you designate as your ProviderOne Security Administrator.  This person will set up additional staff access to ProviderOne and manage their access to ProviderOne for your organization.  Visit the page below for a security checklist to guide you through obtaining security credentials and setting up users in ProviderOne.

 

Step 2

Learn how to complete registration in ProviderOne

DSHS periodically schedules training webinars for providers. Dates and time will be posted on the Training page when available. During webinars, DSHS explains "how to" while providers view the actions taken and have an opportunity to ask questions.

These resources are available to assist you:  

Step 3

Find out what information you need about your organization when you register

 Complete Registration                     

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

Step 4

ProviderOne users obtain log on and password

  • Obtain your log on and password information from your Security Administrator.

Step 5

Obtain your Billing Agent's or Clearinghouse's ProviderOne number

  • You will need their ProviderOne number to complete your registration.  You should get this number directly from your billing agent or clearinghouse.

Step 6

Register in ProviderOne

  • Register your Group.  You should focus first on the information associated at the organization level that could affect our ability to pay you.

  • Register servicing providers.  Once you have completed registration for the organization, you should complete registration for performing providers associated with your business.  You will eventually need to complete registration for all of your performing providers.

  • Don't forget to select the "submit" button once you've completed registration!  Once you select submit, DSHS will be prompted to review your registration and any changes you may have made to your provider file.

Click here to access ProviderOne and register! https://www.waproviderone.org/

(Refer to the DSHS ProviderOne Provider Registration and Security Administration Manual if needed)

Step 10

Test with your billing agent or clearinghouse each HIPAA transaction type you plan to use in ProviderOne. Your billing agent or clearinghouse will follow instructions in the HIPAA Companion Guides to test and make sure it can receive your transactions and submit them to ProviderOne.

Step 11*

Download and review the new DSHS Trading Partner Agreement

* If Needed: If your organization plans to send/receive HIPAA electronic batch files directly to/from DSHS you will need a Trading Partner Agreement (all transaction types - 837, 835, 270/271, etc.)

 


If you have questions, please:

  • Select the appropriate topic below:

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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