Urgent Action Required Regarding Medicaid Rate Increase Add-On

Developmental Disabilities Administration

May 5, 2020

Attention all Medicaid contracted Assisted Living, Adult Family Homes, and Enhanced Services Facilities:

If you have attempted to submit claims for the new “Pandemic-related Extraordinary Services,” using service codes SA020 (with modifier U1, U2, U3, U4, U5, or UD) or SA031, U1 prior to 11 a.m. May 5, you may have encountered an error and denied claim.

These errors occurred because the claim was not split into individual dates of service. This issue has since been resolved. You can resume submitting batch claims for a date range and ProviderOne will break the range into individual days. 

Please resubmit claims that are in denied status for this reason and you should not have any issues. Claims submitted by 5p.m. today (May 5), will be reflected on the RA generated this Friday, May 8, 2020.

If you are unfamiliar with the process for resubmitting claims, please refer to the ProviderOne Billing and Resource Guide: www.hca.wa.gov/assets/billers-and-providers/providerone-billing-and-resource-guide.pdf.

Contact us for questions or feedback.