ProviderOne deducting incorrect client responsibility amount
Some Social Services Providers have reported that the amount of client responsibility deducted from their January 2026 claims do not match the amount applied to the Social Services Authorization line in ProviderOne. The Health Care Authority is aware of this issue and is working to resolve it. HCA will provide an update and next steps as soon as they have more information.
Billing guide updated
The Submitting and Adjusting Social Services Claims Guide was updated effective February 20, 2026. To review the changes, please refer to the Revision History section beginning on page 100 of the guide.
Survey: ProviderOne resources
Over the past two years, DSHS and HCA have collaborated to create and update ProviderOne resources for Social Services Providers (e.g., billing guides, monthly newsletters, FAQs, etc.).
We want to ensure the resources available to you remain useful, user-friendly, and relevant. Please take this brief survey to let us know what's working, what isn't working, and what other resources you would like to see.
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Monthly FAQ: I'm having trouble receiving payment/submitting claims. Who should I contact?
If you are having trouble submitting claims in ProviderOne (e.g., you receive an error message when attempting to enter claims or your claims denied), do the following:
- First review your ProviderOne Authorization List to ensure the authorization is in 'Approved' and 'No Error' status.
- If the Auth is in 'Cancelled' or 'Error' status, contact the client's authorizing case manager. Name and contact information can be found on your Authorization List or the client's Authorization Letter.
- If the auth is in 'Approved' and 'No Error' status:
- Review the claim to ensure all required fields are complete and accurate.
- Validate the information you entered on the claim matches the authorization (i.e., service/procedure code, modifier, units, dates, client ID, authorization #, provider ID).
- Review the ProviderOne for Social Services Billing Guides to ensure you are billing correctly for the type of service code:
- Service codes with a 'Day' unit type can be entered as a date range (e.g., 1/1/2026-1/31/2026) with the total # of units provided for the date range. ProviderOne will split the claim into daily service lines for you.
- Service codes with a '1/4 Hour' unit type or 'Mile' unit type can't be entered as a date range. Codes with these unit types must be entered individually for each date of service and must include the total # of units provided per day.
- If you are a Home Care Agency and you receive an error code after uploading a .DAT claim file or your claims denied, review the Error Code Reference Table found in the Submitting and Adjusting Social Services Claims Guide for an explanation of each error code and information on how to fix the error.
If you have followed all of these steps and are still unable to submit your claims or your claims continue to deny, contact HCA's Medical Assistance Customer Service Center (MACSC) at 1-800-562-3022 or online. MACSC staff will escalate the issue to a supervisor or the DSHS Payments Team as needed.
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