Hca billing guide of Technology
About this guide*. This publication takes effect October 1, 2023, and supersedes earlier billing guides for this program. The Health Care Authority is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800-562-3022.The separate payment applies to services provided on or after January 1, 2024. The billing guide lists the services and revenue codes that are eligible for separate payment, beginning on page 86. The separate payment from the HCA and Medicaid MCOs is required by Senate Bill 5103, passed during the 2023 Legislative Session. This bill was one of ...recent guide, please notify us at . [email protected]. About this guide * This publication takes effect July 1, 2022 and supersedes earlier billing guides to this program. Unless otherwise specified, the program in this guide is governed by the rules found in . WAC 182-550-6400.Verifying eligibility is a two-step process: Step 1. Step 2. Verify the patient's eligibility for Apple Health. For detailed instructions on verifying a patient's eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA's ProviderOne Billing and Resource Guide.Billing Guide . January 1, 2023 . CPT® codes and descriptions only are copyright 2022American Medical Association. CDT® codes and descriptions only are copyright 2022 American Dental Association. 2 | Dental-Related Services Billing Guide Disclaimer Every effort has been made to ensure this guide’s accuracy. If an actual or apparent conflict …By visiting the Washington Healthplanfinder's website. 2. By calling the Customer Support Center toll-free at: 855-WAFINDER. (855-923-4633) or 855-627-9604 (TTY) 3. By mailing the application to: Washington Healthplanfinder, PO Box 946, Olympia, WA 98507 In-person application assistance is also available.Step 1. Verify the patient’s eligibility for Apple Health. For detailed instructions on verifying a patient’s eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA’s. ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.Billing Guide April 1, 2020 Every effort has been made to ensure this guide's accuracy. If an actual or apparent conflict between this ... 2020, and supersedes earlier billing guides to this program. HCA is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1 ...Step 1. Step 2. Verify the patient’s eligibility for Apple Health. For detailed instructions on verifying a patient’s eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA’s ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.recent guide, please notify us at . [email protected]. About this guide * This publication takes effect August 1, 2022, and supersedes earlier billing guides to this program. Unless otherwise specified, the program in this billing guide is governed by . WAC 182-545-900. The Health Care Authority is committed to providing equal access to ...Step 1. Verify the patient’s eligibility for Apple Health. For detailed instructions on verifying a patient’s eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA’s. ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.Use procedure code 96127 or 96160, with up to two units per billing claim line. Caregivers of infants age six months and younger must be screened for depression. Use procedure code 96161 under the infant's ProviderOne client ID. When billing procedure code 96161 for a fee-for-service (FFS) client, use EPA # 870001424.Paying bills is never a pleasant activity, but staying current with your financial obligations is crucial. Using an online bill payment system can streamline this process to make i...In today’s digital age, managing your bills online has become the norm. It offers convenience, efficiency, and allows you to have better control over your finances. When it comes t...section in HCA's ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2. If the patient is not eligible, see the note box below. Step 2. Verify service coverage under the Apple Health client's benefit packageJan 1, 2024 · Step 1. Step 2. Verify the patient’s eligibility for Apple Health. For detailed instructions on verifying a patient’s eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA’s ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.Refer also to HCA's ProviderOne billing and resource guide for valuable information to help you conduct business with the Health Care Authority.Step 1. Verify the patient’s eligibility for Apple Health. For detailed instructions on verifying a patient’s eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA’s ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.Each claim for inpatient psychiatric care must include an authorization number or, for fee-for-service clients, an EPA number. Hospitals must bill a new claim and use the appropriate EPA number depending on voluntary or involuntary status. Refer to HCA’s Mental Health Services Billing Guide for program specifics.Jan 1, 2024 · About this guide*. This publication takes effect January 1, 2024, and supersedes earlier billing guides to this program. The Health Care Authority is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800-562-3022.Substance Use Disorder (SUD) Billing Guide. Step 2. Verify service coverage under the Apple Health client’s benefit package. To deter-mine if the requested service is a covered benefit under the Apple Health client’s bene-fit package, see HCA’s Program Benefit Packages and Scope of Services webpage. Note:Step 1. Step 2. Verify the patient's eligibility for Apple Health. For detailed instructions on verifying a patient's eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA's ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.About this guide*. This publication takes effect April 1, 2024, and supersedes earlier billing guides to this program. The Health Care Authority is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800-562-3022.Applied Behavior Analysis (ABA) Program Billing Guide. Client Eligibility. Most Apple Health clients are enrolled in an HCA-contracted managed care organization (MCO). This means that Apple Health pays a monthly premium to an MCO for providing preventative, primary, specialty, and other health services to Apple Health clients.About this guide∗. This publication takes effect November 3, 2017, and supersedes earlier billing guides to this program. HCA is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800-562-3022. People who have hearing orAbout this guide*. This publication takes effect October 1, 2020, and supersedes earlier billing guides to this program. Unless otherwise specified, the program in this billing guide is governed by WAC 182-3000 through -3400. The Health Care Authority is committed to providing equal access to our services.The Health Care Authority evaluates requests for authorization of covered outpatient rehabilitation services that exceed limitations in this billing guide on a case-by-case basis in accordance with WAC 182-501 0169. The provider must justify that the request is medically necessary (as defined in WAC 182-500-0070) for that client.Sterilization Supplemental Billing Guide. Every effort has been made to ensure this guide’s accuracy. If an actual or apparent conflict between this document and an agency rule arises, the agency rules apply. This publication takes effect January 1, 2020, and supersedes earlier billing guides to this program.HCA has revised its instructions for billing this modifier used to identify off-campus hospital-based services to conform with CMS definitions. The updated guide modifies the definition of modifier PO and adds a reference to 42 CFR § 419.48 for a description of excepted items and services.recent guide, please notify us at [email protected]. About this guide* This publication takes effect July 1, 2020, and supersedes earlier billing guides to this program. The Health Care Authority is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800 ...Coverage Table. When billing HIV/AIDS case management services or monitoring, use the following procedure codes with the appropriate modifier. The Health Care Authority (HCA) pays full-month fees during monitoring. Modifiers U8 and U9 are payer-defined modifiers. U8 means "full month" and U9 means "partial month.".Step 1. Verify the patient's eligibility for Apple Health. For detailed instructions on verifying a patient's eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA's ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.About this guide*. This publication takes effect October 1, 2023, and supersedes earlier billing guides for this program. The Health Care Authority is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800-562-3022.Independently licensed mental health providers. (WAC 182-531-1400) •May provide services described in HCA’s Apple Health Mental Health Billing Guide (Part I) Includes: Psychologist, LMHC, LASW, LICSW, LMFT, Psychiatrist, P-ARNP. Mental health professionals working for a licensed Behavioral Health Agency. (WAC 246-341-0515)recent guide, please notify us at . [email protected]. About this guide 1 This publication takes effect July 1, 2022, and supersedes earlier billing guides to this program. Unless otherwise specified, the program in this billing guide is governed by . chapter 182-540 WAC. The Health Care Authority is committed to providing equal access to ...Obtaining prior authorization, limitation extension, or exception to rule. Fax all documents along with requests 1-866-668-1214. Policy or program oversight for Maternity Support Services. HCA First Steps Program Manager 360-725-1293 Fax: 360-725-1152 Email: [email protected] 1. Verify the patient’s eligibility for Apple Health. For detailed instructions on verifying a patient’s eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA’s ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.recent guide, please notify us at . [email protected]. About this guide * This publication takes effect January 1, 2022 and supersedes earlier billing guides to this program. The Health Care Authority is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1 ...About this guide. 1. This publication takes effect. October 1, 2023. , and supersedes earlier billing guides to this program. Unless otherwise specified, the program in this guide is governed by the rules found in. WAC 182-533-0701. through 182-533-0730. HCA is committed to providing equal access to our services.Step 1. Verify the patient's eligibility for Apple Health. For detailed instructions on verifying a patient's eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA's ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.See the agency's Chemical-Using Pregnant (CUP) Women Program Billing Guide for details. A list of the DBHR Certified Hospitals providing intensive inpatient care for chemical using pregnant women is located on the Department of Social and Health Services' website.Step 1. Verify the patient's eligibility for Apple Health. For detailed instructions on verifying a patient's eligibility for Apple Health, see the Client Eligibility, Benefit Packages, and Coverage Limits section in HCA's ProviderOne Billing and Resource Guide. If the patient is eligible for Apple Health, proceed to Step 2.About this guide*. This publication takes effect April 1, 2021 and supersedes earlier billing guides to this program. The Health Care Authority is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800-562-3022.By visiting the Washington Healthplanfinder's website. 2. By calling the Customer Support Center toll-free at: 855-WAFINDER. (855-923-4633) or 855-627-9604 (TTY) 3. By mailing the application to: Washington Healthplanfinder, PO Box 946, Olympia, WA 98507 In-person application assistance is also available.HCA covers orthodontic treatment and orthodontic-related services, subject to prior authorization requirements and the limitation list within this billing guide, for clients with one of the following medical conditions: • Cleft lip and palate, cleft palate, or cleft lip with alveolar process involvement.We understand that the healthcare billing process can be confusing for patients, so in addition to our online tool, we are also happy to speak with any patient to provide a customized estimate and answer questions over the phone. The customer service numbers for each facility are provided on the facility linked sites below. A - D. E - H. I - L.Jul 1, 2023 · Every effort has been made to ensure this guide’s accuracy. If an actual or apparent conflict between this document and a Health Care Authority (HCA) rule arises, the HCA rule applies. Billing guides are updated on a regular basis. Due to the nature of content change on the internet, we do not fix broken links in past guides. If you find aAcute Physical Medicine and Rehabilitation (PM&R) Billing Guide. Newborn administrative days. Per WAC 182-550-4550, HCA provides up to five days of an inpatient hospital stay for the postpartum parent following the parent’s medical discharge when the newborn remains as an inpatient on a hospital claim at the facility.HCA covers orthodontics for children with cleft lip or palates or severe handicapping malocclusions. HCA reviews all requests for orthodontic treatment or orthodontic-related services for clients who are eligible for services under the EPSDT program (WAC 182-534-0100). See HCA's Orthodontic Services Billing Guide.The separate payment applies to services provided on or after January 1, 2024. The billing guide lists the services and revenue codes that are eligible for separate payment, beginning on page 86. The separate payment from the HCA and Medicaid MCOs is required by Senate Bill 5103, passed during the 2023 Legislative Session. This bill was one of ...HCA evaluates a request for orthodontic treatment and orthodontic-related services that are in excess of the limitations or restrictions listed within this billing guide, according to WAC 182-501-0169. Orthodontic treatment must meet industry standards and correct the medical issue.About this guide*. This publication takes effect October 1, 2020, and supersedes earlier billing guides to this program. The Health Care Authority is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800-562-3022.Each claim for inpatient psychiatric care must include an authorization number or, for fee-for-service clients, an EPA number. Hospitals must bill a new claim and use the appropriate EPA number depending on voluntary or involuntary status. Refer to HCA's Mental Health Services Billing Guide for program specifics.Use procedure code 96127 or 96160, with up to two units per billing claim line. Caregivers of infants age six months and younger must be screened for depression. Use procedure code 96161 under the infant’s ProviderOne client ID. When billing procedure code 96161 for a fee-for-service (FFS) client, use EPA # 870001424.About this guide. ∗. This guide takes effect January 1, 2020, and supersedes earlier billing guides to this program. HCA is committed to providing equal access to our services. If you need an accommodation or require documents in another format, please call 1-800-562-3022. People who have hearing orClients age 20 and younger. Use EPA #870001405 when billing. Durable medical equipment (DME) and pharmacy providers must complete and retain the following forms in the client's file: Metabolic Disorders - Oral Enteral Nutrition Expedited Prior Authorization (EPA) Worksheet: Children (HCA 13-101) form. About this guide. 1. This publication takes effecJan 1, 2024 · Step 1. Verify the patient’sRelated outpatient hospital services, including pre-a
