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Washington State Dental Association

HCA Paperless Claims Reminder

Reminder: Effective April 2017, the Health Care Authority (HCA) will accept only electronic claims from providers that have never submitted electronic claims for Apple Health (Medicaid) services. If your practice hasn’t already converted to electronic claims or direct data entry submissions, your practice will need to transition to the new electronic claim submission standard.

Tools to help get started

To assist in this transition, HCA has identified the following items required to get started:

  • HCA Security Access form: The ProviderOne User Access Request form designates the “System Administrator(s)” among your staff who will help your practice access ProviderOne and submit claims
  • List of Third Party Administrators (TPAs): This lists companies (TPAs) that are contracted with HCA to submit electronic claims on behalf of providers

Supported operating systems and internet browsers

ProviderOne is compatible with the following computer operating systems and internet browsers:

Computer operating systems

  • Windows: 10, 8.1, 8, 7
  • Macintosh: OS 10.12 Sierra, OS X 10.11 El Capitan, OS X 10.10 Yosemite

Internet browsers supported

  • Internet Explorer: 11, 10
  • Google Chrome: 55.0.2883, 54.0.2840
  • Firefox: 50.0.2, 45.5.1 ESR
  • Safari: 10.0.1

Where do I send the form?

Complete and return the HCA Security Access form to:

HCA IT Security, P.O. Box 45512, Olympia, WA 98504-5512

Or fax the completed forms to HCA IT Security at: (360) 507-9019. Or email to provideronesecurity@hca.wa.gov.

If you have been provided your System Administrator profile and need to add profiles for submitting claims or add additional users, please review this document created by the ProviderOne Security team.

How can I learn more?

HCA will be scheduling a series of webinars between January and March 2017 to assist providers on the transition to electronic claims submission. These webinars will be recorded and available online for future use. More information about the webinars will be forthcoming.

Filing for exemption

During this transition from paper to the electronic claim submission requirement, some providers may need to seek approval to submit paper claims if there is a temporary or long-term situation outside of their control that precludes submission of electronic claims. Examples of these unusual circumstances may include but are not limited to:

  1. The provider can demonstrate that the information needed for adjudication of an Apple Health (Medicaid) claim cannot be submitted electronically by the effective date using the claim formats required under the ProviderOne Billing and Resource Guide. The provider must demonstrate that they are working on implementing their transition (e.g., acquisition of software application; contracting with HCA approved claims billing clearing house; adopting Direct Data Entry; etc.).
  2. The provider is experiencing a disruption in their electricity or communication connection that is outside of their control and is expected to last longer than two days. This exception applies only while electricity or electronic communication is disrupted. 
  3. HCA notifies the provider in writing that paper claims will be accepted due to ProviderOne System issues precluding acceptance of electronic claims.

Providers wishing to ask for an exemption from submitting claims electronically may do so using the Request a Waiver from Electronic Billing form located on our ProviderOne Billing and Resource Guide web page under “Paperless billing has arrived!”

What if I need more help?

If you need further information regarding this notice, please contact the HCA Customer Service Center at (800) 562-3022.

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