The way you get paid is changing
In late 2014, the way you get paid for Medicaid* services will change. Providers, like you, who receive payment for serving Medicaid-eligible clients, will transition from the Social Service Payment System (SSPS) to the online system known as ProviderOne Phase 2.
What it's all about
ProviderOne is an efficient and electronic system that will allow social services providers (such as adult family homes, supported living, and home care agencies) and medical providers (such as nurse delegators and adult day health) to enjoy greater flexibility in managing their Medicaid claims.
It’s time to get on board with ProviderOne
Change is difficult but often necessary. This transition from a 30 year old phone and paper billing system to the online system will offer convenience and greater ease of management of your Medicaid claims. In making this transition, you may feel wary and unsure. It’s our job to make this journey as seamless as possible. We have put together a series of presentations that will offer you and other providers a glimpse into the basic concepts of the payment processing and claims management system that is ProviderOne (See Get an Early Look video presentation).
Social service providers and “batch upload” billing
Soon, select providers (for example, assisted living, home care agencies, home-delivered meals, supported living, and personal emergency response) will be receiving information about the billing method called social services batch upload (See factsheet). Get an Early Look (referenced above) is a five-minute presentation on the different billing methods.
Other user-friendly modules are coming. They will give you a sneak peek into the way ProviderOne looks and works, and how it offers you greater control in processing claims and managing your payments. As we lead up to the enrollment and billing go-live phases of the project, we will roll out other presentations.
Phase 2 of the ProviderOne project affects providers categorized as 1099 providers
The second phase of the project - known as "Phase 2"- will expand payment processing to include social service providers such as community residential providers, home care agencies, and medical providers that did not transition in the first phase of the project.
- Adult Day Health
- Adult Family Homes
- Alternative Living
- Assisted Living Facilities
- Companion Homes
- Durable Medical Equipment
- Group Homes/Group Training Homes
- Home Care Agencies
- Home Delivered Meals
- Licensed Staff Residential
- Mental and Physical Incapacity Evaluations
- Nurse Delegation
- Personal Emergency Response System
- Physical, Occupational, Speech Therapy; Counseling
- Private Duty Nursing
- Skilled Nursing
- Supported Living
Certified caregivers known as W-2 individual providers are the other large group who will transition to Phase 2:
There are roughly 40,000 Individual providers are represented by Service Employees International Union Healthcare 775NW.
*Medicaid in Washington State is now called Washington Apple Health.