For children with disabilities, ages 0 through 20, receiving early intervention or special education services

September 2024

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In this issue

• Reminders for School-Based Health Care Services coordinators
• Medicaid revalidation
• Enrolling providers in ProviderOne
• What has changed in the SBHS billing guide?
• About SBHS

Reminders for School-Based Health Care Services coordinators

Welcome back to a new school year!

Annual requirements for coordinators

Download the Annual Checklist for SBHS Coordinators (wa.gov) to assist with annual School-Based Health Care Services (SBHS) requirements.

• Update the provider contact update form and email it to Katie Shaler, SBHS program manager by October 31.
• View annual training for SBHS coordinators: video | pdf
• Enroll new providers in ProviderOne.
• View the SBHS Billing Guide, updated August 1, 2024.

Medicaid revalidation

School districts participating in the SBHS program are required to complete Medicaid revalidation every five years.

What is Medicaid revalidation?

Federal regulations require state Medicaid agencies to revalidate the enrollment of Medicaid providers once every five years. During the provider revalidation process, your school district will need to update a few forms and may need to update information in ProviderOne.

Revalidation is required for school districts (also known as "billing providers"). Servicing providers enrolled under a district's ProviderOne account do not have to complete revalidation. 

Is my school district due for revalidation?

The district will be notified by mail when it is time for revalidation. The revalidation notice will be sent to the mailing address listed in ProviderOne. 

If you are up for revalidation in 2024, you may have received an email from Katie Shaler, SBHS program manager, asking for you to begin this process by logging into ProviderOne.

My school district received a revalidation letter. What is the district required to do?

The revalidation letter specifies the requirements to complete the revalidation. Requirements are also summarized below.

School districts must complete the following steps.

1. Log in to the district's ProviderOne account via OneHealthPort.
2. Once logged into ProviderOne, click on "Manage Provider Information". This link will take you to the Business Process Wizard (BPW) where you will need to review and update the district's information.
3. Sign and upload the following documents:
   • Core Provider Agreement
   • Debarment Statement 
   • Internal Revenue Service (IRS) W-9 form
   • Trading Partner Agreement

The forms must be signed by the person listed as a "Managing Employee" under Step 4: Ownership and Managing Controlling Interests in ProviderOne. 

Questions?

For assistance with the Medicaid revalidation process, visit HCA's Revalidation webpage.

If you have already started the process but have not received a revalidation letter, contact Provider Enrollment.

• Provider Enrollment email: ProviderEnrollment@hca.wa.gov.
• Provider Enrollment phone: 1-800-562-3022 ext. 16137.
• Phones are open: Tuesdays and Thursdays from 7:30 a.m. to 4:30 p.m. (closed from noon -1:00 p.m.).
• Phones are closed: Mondays, Wednesdays, and Fridays.

Enrolling providers in ProviderOne

To receive Medicaid reimbursement for IEP/IFSP health-related services, school districts must enroll providers (e.g., speech therapists, physical and occupational therapists, nurses, etc.) as servicing providers under the district's ProviderOne account.

• How to enroll providers in ProviderOne.

What to expect after submitting a provider application in ProviderOne

• HCA strives to process applications within 30 days from when they are received.
• An application may take longer to process if it:
  • Is from out-of-state.
  • Requires program approval.
  • Is missing required information or documents. HCA will contact the district via the email address entered on the provider application if additional information is required.
• If the provider's enrollment application is approved, HCA will mail a welcome letter to the mailing address listed on the district's ProviderOne file. 

Questions?

If you need help enrolling providers in ProviderOne, contact HCA's Office of Provider Enrollment.

• Provider Enrollment email: ProviderEnrollment@hca.wa.gov.
• Provider Enrollment phone: 1-800-562-3022 ext. 16137.
• Phones are open: Tuesdays and Thursdays from 7:30 a.m. to 4:30 p.m. (closed from noon -1:00 p.m.).
• Phones are closed: Mondays, Wednesdays, and Fridays.

What has changed in the SBHS billing guide?

• Defined “established relationship” consistent with RCW 74.09.325.
• Added a new note box to comply with audio-only telemedicine requirements in RCW 74.09.325.

View the updated School-Based Health Care Services billing guide.

About SBHS

The Washington State School-Based Health Care Services (SBHS) Program is administered by the Health Care Authority (HCA). School districts participating in the SBHS Program may receive Medicaid reimbursement for providing health care-related services to Title XIX Medicaid-eligible students with Individualized Education Programs (IEPs) or Individualized Family Service Plans (IFSPs).

Please feel free to share SBHS Program news with your colleagues! If you are not currently subscribed, sign up to receive SBHS Program updates.