ProviderOne changes to support enhanced Apple Health (Medicaid) Provider Directory

Washington State Health Care Authority sent this bulletin at 04/30/2021 08:31 AM PDT

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ProviderOne changes to support enhanced Apple Health (Medicaid) Provider Directory

The Health Care Authority (HCA) sends you this notification to let you know about changes we are making to ProviderOne. These changes will support an improved experience for Apple Health (Medicaid) clients when searching for a provider and will require that you update your ProviderOne provider file.

What is happening?

On March 9, 2020, CMS released an interoperability rule which, in part, requires provider directory information to be made available to Apple Health clients. The interoperability rules are mandated and were put in place to benefit Apple Health clients and create better access to health care.

What is HCA doing?

To help our clients and remain in compliance with the new interoperability requirements, HCA will be creating a new Provider Directory tool. This will replace our existing Find a Provider tool and offer an improved experience with the following new features:

Billing providers will be able to associate their servicing providers to a specific servicing location
Billing providers will be able to associate taxonomies to a specific servicing location
Apple Health clients will be able to utilize the Provider Directory within a specific location via third party application – increasing client satisfaction and connection to health care

The new Provider Directory data will be available for clients to access on December 10, 2021. We will keep you updated as we move towards our launch date.

I am a provider. What do I need to do?

Action will soon be required on your part to get ready for this change.

We are currently developing a user guide for your reference when making changes to your provider file, and will distribute it once complete.

Stay tuned and keep checking your email for updates!

Questions?

If you have any questions regarding these changes or your ProviderOne provider file, please contact HCA through one of the following channels.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care 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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The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.