|
ProviderOne Newsletter:
DSHS Social Services Providers
April 2025
|
|
ProviderOne Billing Guides
DSHS & HCA have been busy updating and consolidating the ProviderOne for Social Services billing guides. The new guides will be published to the ProviderOne for Social Services webpage within the next couple of months. We will notify providers via email when the new guides are available. After the guides are published, DSHS & HCA will host provider trainings to review the new guides, as well as to review ProviderOne basics. Be on the lookout for emails about these upcoming trainings!
|
|
Reminders
Upcoming trainings for Adult Family Homes:
|
|
Monthly FAQ: Why are there claim adjustments on my RA and how do adjustments impact my payments?
Claim adjustments can be initiated by either you (the provider) or DSHS. Paid claims may be adjusted for a variety of reasons including, but not limited to:
- The rate or units on an authorization changed after you already received payment
- You received payment when you shouldn’t have (i.e., services weren't provided)
- You claimed for too many units or were paid the wrong rate, etc.
When claims are adjusted, you will find a summary of the adjusted claims on the Payment Summary section of your remittance advice (RA). In addition, a breakdown of each adjusted claim can be found in the Adjustments Claim Category within the Payment Information section of the RA.
We have updated the following resource to include more information about adjusted claims including explanations of the most common Social Services adjustment reason codes, adjustment types, and the difference between offset and non-offset adjustments:
Understanding each section of the RA
|
|
Resource spotlight
New provider corner
|
|
About the newsletter
The ProviderOne for DSHS Social Services Providers Newsletter is published monthly by the Department of Social & Health Services (DSHS) in collaboration with the Health Care Authority (HCA). The intent of the newsletter is to share ProviderOne information, updates, and resources for DSHS-contracted providers who submit authorized claims through the ProviderOne system.
Visit the ProviderOne for Social Services webpage to view past newsletters and to read more about ProviderOne for Social Services.
Sign up to receive the monthly newsletter and other ProviderOne for Social Services notifications.
|
|
|
|
