Federal regulations require state Medicaid agencies to revalidate the enrollment of all Medicaid providers once every five years (42 CFR Part 455). Instructions on when to revalidate and how to complete your revalidation can be found on this page.
On this page
You will be notified by mail when you are selected for revalidation. No action is required until you receive the revalidation letter from HCA.
When selected for revalidation, a single letter is mailed to the group or facility being revalidated. Revalidation letters are not sent to individual providers working in a clinic.
The revalidation notice will be sent to the mailing address listed in ProviderOne. To ensure the revalidation notification reaches your office, please login to ProviderOne to confirm your mailing address is up-to-date.
If you need assistance logging in to ProviderOne, please contact ProviderOne Security.
The revalidation notice you received will specify the requirements for the National Provider Identifier (NPI) listed on the letter. Complete all steps listed on the revalidation checklist that you received.
Note: You have 30 days from the date on the notice to provide the requested information. Your Medicaid billing privileges will be affected if you do not provide the requested information by the deadline.
Complete the revalidation steps
All providers are required to complete the following steps. For assistance with the revalidation process, see the revalidation FAQ.
- Login to the ProviderOne portal. Review and update your information using the ProviderOne Business Process Wizard (BPW). For assistance with the BPW, see our step-by-step instructions.
Important: You must submit updated disclosures of ownership, managing employees, and other controlling interests during Step 4 of the ProviderOne Business Process Wizard (BPW).
- Submit a signed Core Provider Agreement (form 09-015) and Debarment Statement (form 09-016).
- Submit an Internal Revenue Service (IRS) W-9 form.
- Submit additional required documents*. Certain provider types must submit additional materials. Be sure to submit all that apply to your provider type. Below are the most common:
- Copy of business license
- Copy of current Clinical Laboratory Improvement Amendments (CLIA)
- Copy of current hospital license
- Copy of current professional license
- Copy of current pharmacy license
- Trading Partner Agreement
- Copy of current ambulance license
- DMEs must be Medicare certified
* Please review the full list of required documents by provider type to see if any other documents pertain to you.
Submit required documents
Once you have completed the revalidation steps, return all required documents—along with the revalidation notice and checklist—to:
Washington State Health Care Authority
P O Box 45562
Olympia, WA 98504-5562
You may also submit by:
- Fax: 360-725-2144
- Email: HCAPR@hca.wa.gov
Note: This email is secure only if you use an encryption service. Provider Enrollment can help you if you have questions about encrypting your email.