Enroll as a health care professional practicing under a group or facility

Am I eligible to enroll as an Apple Health (Medicaid) servicing provider?

Health care professionals practicing under a group or facility are called servicing providers. To find out if you are eligible to be a servicing provider, please refer to the listing of eligible provider types for Washington.

Important! The group or facility under which you practice must be enrolled with HCA as a billing provider and have a Core Provider Agreement with the agency. Servicing provider applications submitted without a billing provider will be denied.

Do I need to submit additional documents?

Additional forms are not required to enroll as a servicing provider. However provider-specific documents may be required depending on your provider type.

Submitting provider-specific documents

After your application has been submitted for review:

1. Enter your 16-digit application number.
2. Print the document submission cover sheet

Attach the cover sheet as the first page to all required documentation.

I need assistance with the online application, what do I do?

There are multiple ways to obtain assistance with enrolling a servicing provider:

• Follow the step-by-step instructions in the ProviderOne How to Enroll a Servicing Provider user manual.
• Contact Provider Enrollment 1-800-562-3022 ext. 16137
  Phone hours: 7:30 a.m. - 4:30 p.m.
  (Phones are down on Wednesdays and weekdays between noon and 1 p.m.).
• Submit a help request.

How long is the application?

The online application has 17 steps. Steps 1, 3, 5, 14*, 16, 17 are required.

*Step 14 “Add Billing Provider Details” indicates it is “optional” however this step is required.