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ProviderOne Billing and Resource Guide

Washington Apple Health (Medicaid) ProviderOne Billing and Resource Guide September 2022 ProviderOne Billing and Resource Guide Every effort has been made to ensure this Guide s accuracy. However, in the unlikely event of an actual or apparent conflict between this document and an agency rule, the agency rule controls. 2 About this Guide This Guide supersedes all previously published agency ProviderOne Billing and Resource Guides. What has changed? REASON FOR CHANGE PAGE NUMBER SUBJECT CHANGE HCA website refresh Various Website hyperlinks Updated website links and updated name of ProviderOne Resources hyperlink to Learn ProviderOne . HCA accepts only electronic claims for Apple Health (Medicaid) services, except under limited circumstances. Providers may seek approval to submit paper claims if they are in a temporary or long-term situation outside of their control that precludes submission of claims electronically.

• Schedule client appointments or check in patients on the day they receive services • Submit fee for service (FFS) claims to HCA • Post and reconcile payments This guide assumes familiarity with standard medical billing practices and coding. NOTE: This guide does not include billing information for the pharmacy point-of-sale (POS) system ...

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