SBHS Quarterly Newsletter

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In this issue

Are nursing services and mental health services billable through the SBHS program?

Yes! The majority of SBHS-contracted school districts bill for OT, PT, and speech services as those are the most common related services included in an IEP/IFSP. However, nursing services (e.g., medication administration, catheterization care, tube feedings, seizure management, etc.) and mental health services (i.e., individual and group counseling) are also billable through the SBHS Program.

Nursing and mental health services are covered when they are:

  • Prescribed or recommended by a Department of Health (DOH)-licensed provider per their scope of practice
  • Included in the IEP or IFSP summary of service matrix as a related service
  • Provided by or under the direction of a DOH-licensed provider (school staff or contracted provider)
    • Services provided by non-licensed school staff are reimbursable as long as staff are supervised by a DOH-licensed provider

More information on how to bill for nursing and counseling services can be found in the SBHS Billing Guide. Districts can also contact HCA's SBHS Program Manager for more information. 

SBHS Quarterly Newsletter

February 2023

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). Visit the SBHS webpage for more information.

Please feel free to share SBHS news with your colleagues!

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OneHealthPort registration

The Health Care Authority (HCA) is requiring Medicaid providers (including school districts, ESDs, and charter schools who participate in the SBHS program) to register with OneHealthPort (OHP). 

Is OneHealthPort replacing ProviderOne?

No. After a district sets up their OHP account, school district staff (e.g., SBHS Medicaid Coordinators) will access ProviderOne through OHP.

What happens if I don't register with OneHealthPort?

All SBHS-participating school districts, ESDs, charter schools and billing agents who assist districts with Medicaid billing must register for OneHealthPort to access ProviderOne before current ProviderOne sign-on credentials are made inactive. As of today, there is no "deadline" to register but HCA encourages school districts and billing agents to register with OHP by the end of the 2022-23 school year. 

How do I register with OHP?

More information about OneHealthPort, how to register with OHP, and other frequently asked questions can be found in the SBHS OneHealthPort FAQ. (Note: This FAQ is intended only for SBHS-contracted school districts/ESDs).

SBHS A-19 invoices and claims information

Important Information

HCA's SBHS program manager continues to receive questions from school districts about invoicing, how to review paid claims, and information regarding the funding breakdown of SBHS claims.

District Medicaid Coordinators--please share the following information  with your district's accounts payable staff:

Services provided after July 1, 2022

This is a reminder that HCA is no longer invoicing or providing school districts with a spreadsheet of billed claims for services provided after July 1, 2022. 

School districts can track SBHS payments, as well as paid and denied claims, on the remittance advice (RA):

Reading the remittance advice

The funding breakdown for services provided after July 1, 2022 is 56.2% federal funds and 43.8% state funds.  

Services provided prior to July 1, 2022

HCA continues to invoice school districts for services provided prior to July 1, 2022. If your district received an invoice for services provided during the 2021-22 school year, please submit local match to HCA ASAP.

Currently there are 20 school districts who have outstanding invoices. School districts may contact HCA's SBHS program manager to inquire if they have any outstanding invoices. 

The funding breakdown for services provided prior to July 1, 2022 is 56.2% federal, 26.28% school district match, & 17.52% state funds.

Update to WAC 182-537-0700

HCA is in the process of updating SBHS Washington Administrative Code (WAC) 182-537-0700: School district documentation requirements

Updates include:

  • Terminating the provider signature log requirement
  • Updating language around electronic signature and electronic records 

The WAC is expected to be finalized later this year. HCA's SBHS program manager will notify districts via GovDelivery once it is approved.

Until the WAC changes are approved, school districts are still required to maintain a signature log of all DOH-licensed providers who participate in the SBHS program. The signature log should be kept on file at the district and does not need to be provided to HCA unless requested.