Updated ProviderOne Billing Guides Coming Soon
From the DSHS Newsletter:
DSHS & HCA have been busy updating and consolidating the ProviderOne for Social Services billing guides. The new guides will be published to the ProviderOne for Social Services webpage within the next couple of months. We will notify providers via email when the new guides are available. After the guides are published, DSHS & HCA will host provider trainings to review the new guides, as well as to review ProviderOne basics. Be on the lookout for emails about these upcoming trainings!
Monthly FAQ:
Claim adjustments can be initiated by either you (the provider) or DSHS. Paid claims may be adjusted for a variety of reasons including, but not limited to:
- The rate or units on an authorization changed after you already received payment
- You received payment when you shouldn’t have (i.e., services weren’t provided)
- You claimed for too many units or were paid the wrong rate, etc.
When claims are adjusted, you will find a summary of the adjusted claims on the Payment Summary section of your remittance advice (RA). In addition, a breakdown of each adjusted claim can be found in the Adjustments Claim Category within the Payment Information section of the RA.
We have updated the following resource to include more information about adjusted claims including explanations of the most common Social Services adjustment reason codes, adjustment types, and the difference between offset and non-offset adjustments:
Resource Spotlight
New Provider Corner
Questions?
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