Apple Health: Update to ambulance transportation claim submissions

Washington State Health Care Authority sent this bulletin at 07/25/2017 04:33 PM PDT

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Apple Health (Medicaid) Provider Alert

Effective for dates of service on and after September 1, 2017, the Health Care Authority (the agency) will require ambulance providers to submit a trip report/run sheet with each claim for Advance Life Support (ALS) level transports. This change is due to recent ProviderOne system updates.

Specifically, providers need to know the following:

The narrative on the trip report/run sheet must reflect whether or not an ALS assessment or intervention was performed, and list the actual interventions that were performed.
Claims for ALS level trips will be automatically denied if supporting documentation is not present upon submission.

The agency will update the Ambulance and ITA Billing Guide by September 1, 2017, to reflect this new requirement. A provider alert will be sent when the updated guide is published.

Please direct questions or concerns to Shauna Penn, Ambulance and ITA Program Manager.

About the Health Care Authority (HCA)

The Washington State Health Care Authority purchases health care for more than 2 million Washington residents through Apple Health (Medicaid) and the Public Employees Benefits Board (PEBB) Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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