Reminders:
All providers
Rate changes
Based on the budget passed by the Legislature in July 2024, the rates for some social service codes may have changed. Rates can be found on the Office of Rates Management (ORM) website.
When a change is made to an authorization (i.e., a rate change has occurred), you will receive a ProviderOne notification based on your P1 communication preferences. For step-by-step directions on how to view your clients' authorizations and the associated rates, as well as how to view the history of a particular authorization to see what has changed, please review the Viewing Authorization List billing guide.
PERS vendors
Best practice for submitting PERS claims
In 2022, DSHS and HCA updated how we pay for Personal Emergency Response Systems (PERS). Previously, PERS vendors received a pro-rated amount if a client's eligibility changed mid-month. Since 2022, PERS claims are now paid the full rate of the authorization whether it is for one day or for the full month.
Best practice for PERS vendors is to submit a claim in ProviderOne for the first day of the month of service instead of the whole month. This will minimize action needed by the vendor if a client becomes ineligible for services mid-month.
Example: Client is approved for PERS for 8/1/2024-8/31/2024. Instead of PERS vendor submitting a claim for 8/1/2024-8/31/2024, vendor would submit a claim for 8/1/2024-8/1/2024.
If you have any questions, please reach out to p1_escalation@dshs.wa.gov.
|
