ProviderOne billing guide webinar recording available
Last month, DSHS hosted two webinars for Social Services Providers where we shared information about the updated ProviderOne for Social Services billing guides and reviewed some ProviderOne basics. For those who couldn't attend, a recording of the webinar and the slide deck are now available:
Note about Q&As: We received a lot of great questions during the webinars! We are still compiling answers to all of your questions and will post a Q&A document to our webpage within the next few weeks. If you have questions in the meantime, please see the Social Services Provider contact list.
Billing guides updated July 2025
As a reminder, the ProviderOne for Social Services billing guides are available on the ProviderOne for Social Services webpage. After publishing the guides in June 2025, DSHS identified a few corrections that were needed. These changes have been made, and the revised guides have been reposted. Changes include:
- Adding hyperlinks within the Table of Contents and throughout the guides for ease of navigation.
- Reordering pages within the claim template batch sections.
- Removing the following embedded attachments and adding them as separate documents on our webpage:
Reporting medical leave
Per Medicaid rules, DSHS cannot pay for residential care services (RCS), residential add-ons, or in-home personal care services (PCS) when a client is on medical leave for more than 24 hours (i.e., admitted to a hospital or a skilled nursing facility-SNF). Residential providers and in-home care agencies must notify the client's case manager/social worker per the requirements outlined in their DSHS contract when a client is on medical leave.
It is very important to notify the case manager timely so that the authorization can be modified appropriately and so that the case manager can notify other providers as needed. In addition, providers should not bill for services when a client is not in their eligible setting. DSHS will deny claims or assess an overpayment if claims are submitted for RCS, add-ons, or PCS while the client is on medical leave.
Questions? Refer to your DSHS Medicaid contract. Contact the client's authorizing case manager for questions on how/when to report medical leave.
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