ProviderOne for social services
Find information for social services providers—unique ProviderOne users who contract with the Department of Social and Health Services (DSHS) and have their own authorization and claims submission processes.
Is this page for me?
- 1099 social services-only provider
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Nonmedical social service providers:
- Receive a 1099 tax form from the state of Washington.
- Provide services to clients who are eligible for Medicaid services.
- Have a contract with DSHS.
- Have business performing home care services.
- Receive payment through use of a social services authorization.
If the above information is true, this page is for you!
- 1099 social services medical provider
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Social service and medical providers:
- Receive a 1099 tax form from the state of Washington.
- Provide services to clients who are eligible for Medicaid services.
- Have a contract with DSHS and a Core Provider Agreement (CPA) with HCA.
- Have a business performing home care services and are a licensed medical professional.
- Receive payment through use of a social services authorization or medical claims.
- Have a National Provider Identifier (NPI).
If the above information is true, this page is for you!
- Individual providers (IPs)
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IPs are caregivers who provide certain types of services in a client's home and community such as in-home personal care and respite services.
How do I become an IP?
To become an IP, apply with Consumer Direct Care Network Washington (CDWA).
How do I verify my wages?
To verify your wages:
- Prior to May 2022, paid by IPOne: Send your requests to DSHS.
- On or after October 2021, paid by CDWA: Visit The Work Number website, or call 1-800-367-5690 (employer code: 29876).
Training materials
The following training materials are for ProviderOne users billing for social services and social service medical claims.
Claim submission deadline
The ProviderOne claim submission deadline is every Tuesday at 5 p.m. for payment the following Monday.
Billing essentials and managing provider files and users
- Getting started with ProviderOne - Covers basic navigation, pop-ups and browsers, password troubleshooting, and managing alerts.
- Managing provider data
- Adding new users and assigning profiles
Viewing authorizations
Submitting and adjusting social service claims
- Submitting social service claims
- Creating social service templates
- Adjust, void, and resubmit social service claims
Submitting and adjusting social service medical claims
- Submitting social service medical claims
- Creating social service medical templates
- Adjust, void, and resubmit social service medical claims
Creating and submitting batch claims
- Creating and submitting social service batch claims
- Creating and submitting social service medical batch claims
- ProviderOne batch upload setup guide
- .DAT file formatting requirements
Viewing claim status and remittance advice
Resources
- FAQ: Social service overpayments
- FAQ: ProviderOne setup and payment information for new providers
- DSHS Electronic Visit Verification (EVV) information and resources (personal care and respite care services)
- DSHS: How to turn off pop-up blockers (to access ProviderOne)
Updates and newsletters
Subscribe to the ProviderOne for social services mailing list to receive our monthly newsletter and to get the latest ProviderOne updates impacting DSHS social services providers. DSHS social services providers are also encouraged to sign up for other DSHS alerts and HCA alerts that may impact your business.