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Prior authorization, claims, and billing

As an enrolled Apple Health (Medicaid) provider, you determine client eligibility, submit claims for eligible services, and are paid through the ProviderOne billing and claims system. In this section, learn how to request prior authorization (PA) for servicessubmit claimsaccess provider billing guides and fee schedules, and find hospital reimbursement information.

Important! ProviderOne claims submission deadlines. The deadline is every Tuesday at 5 p.m. for payment the following Monday. The data exchange with the state financial office occurs on Thursdays and Fridays. Providers may see a Friday date on their Remittance Advice.

Due to COVID-19, HCA’s lobby is closed. Learn more about your customer service options.

HCA is closed Thursday, November 26 and Friday, November 27. All Apple Health (Medicaid), PEBB, and SEBB customer services phones lines will be down after 5 p.m. Wednesday, November 25 through Monday morning, November 30.