As of Wednesday, March 18, HCA’s lobby is closed. In-person customer services for Apple Health and the PEBB and SEBB Programs will not be available. Learn more.
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 services, submit claims, access 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.