managing provider data · the ‘managing provider data’ how-to provides instruction on...

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Manage Provider Data

The ‘Managing Provider Data’ How-To provides instruction on navigating to the Provider Data

screen. Here you will learn how to look up and edit:

Basic Information ………………………. 4

Submitting Changes for Review……….5

Locations…………………………………. 8

Contract Details………………………….14

Payment & Remittance Details………..15

Note:

We previously covered profiles and the tasks associated to those profiles. Be mindful that those with

System Administrator access have the ability to lock other users out of the domain.

The System Administrator does not have the ability to make the changes that this tutorial will cover.

In order to make these changes, please use your EXT Social Services or EXT Social Services Medi-

cal profiles.

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As a social service provider,

your provider information is

preloaded into ProviderOne

based on your DSHS contract

information.

Your lines of business are

combined within a single

domain, which is the 7 digit

ProviderOne ID that you

used to log in,

This domain includes all

the social service contracts

linked to your tax identifica-

tion number,

To view and modify your

provider data, click on

‘Manage Provider Infor-

mation‘.

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Here, we see the Update Provider Data

page.

As a social service provider, you will

need to check the data in the following

steps:

Step 1: Basic Information

Step 2: Locations

Step 8: Contract Details

Step 15: Payment and Remittance

Details

Step 16/17: Submit Modifications for

Review

(Providers may have 17 steps dependent on if

there is union information included in the list of

steps.)

Note: Viewing or modifying steps 3-7

and 9-14 is not recommended and could

result in changes to the status of the

step and payment difficulties.

If you made a modification but would

like to cancel it, click on Undo Update

prior to Step 16 submitting the changes.

Some steps are for optional information

and do not require your attention.

Update Provider Data Page

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Step 1: Basic Information

From the ‘View/Update Provider Data’ page, click on Step 1: Basic Information. The provider details pop-up appears.

Here you can see:

Update Provider Data Page/ Basic Information

Provider/Organization

Name

Federal Employer Tax

Number

Organization Business

Name

Organizational Infor-

mation

W-9 Entity Type UBI

Note: Make sure the primary email Is correct as

this is the email that will be used for communication.

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Updating and Submitting for Review

Once you have made any

changes, you will see an update

to the ‘Modification Status’.

If you did not modify any data

and used Cancel to close the

pop-up, the Modification Status

will be blank

If you modified data and used

OK to close the pop-up, the Up-

date will appear in the Modifica-

tion Status

Note:

An updated Modification Status does

not mean that the changes have been

submitted to ProviderOne for review.

This will be covered in Submitting

Modifications for Review.

Update Provider Data Page

Updated

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Submitting Modifications for Review

To submit modifications for re-

view, do the following:

From the View/Update Provider

Data page, click on Step 16:

Submit Modifications for Review.

The Final Submission page ap-

pears.

Click on Submit Provider Modifi-

cation.

Submit Provider Modification will

turn gray. Click on close.

Note:

Step 16/17 must be completed before

any updates can be reviewed and ap-

proved. Make sure all changes have

been completed before submitting

for review.

Providers may have 17 steps depend-

ent on if there is union information in-

cluded in the list of steps.

Final Submission Page

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Submitting Modifications for Review

Once you have made and

submitted your modifica-

tions, you will be returned to

the ‘View/Update Provider

Data’ page.

Here, you will now see any

modifications made having

an ‘In Review’ status.

Note:

Modifications can take 24

hours to update from ‘In Re-

view’ to ‘Complete’.

(time based on Mon-Fri

business hours)

View/Update Provider Data Page

In Review

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Step 2: Locations

Locations are the physical locations or addresses where you currently provide social services. To view information about locations:

From the ‘View/Update Provider Data’ page click on Step 2: Locations,

The ‘Provider Locations’ page appears showing all the locations within your domain.

Note:

The Location Code is a 2 digit number that is added to your 7 digit domain or Provider ID. This creates a 9 digit Provider ID that is used

for your authorizations. All authorizations are linked to a single location. If you provide social service medical, you will have an “00” loca-

tion.

Update Provider Data Page/ Locations

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Step 2: Locations

View and correct data as needed.

Each location can have a unique con-

tact, or share the same contact as the

domain. Verify the email address for

each location. To do this:

From the ‘View/Update Provider

Data’ page click on Step 2: Loca-

tions,

Click on a location code number,

The ‘Location Details’ page ap-

pears. Verify information such as

the preferred communication pref-

erence.

Email is the default communications

preference. Each location can have a

different notification meth-

od.

Once you have made your

updates, click ‘Save’ to re-

turn to the View/Update

Provider Data page. From

there submit any modifica-

tions made for review.

Note: Blue numbers and

words in ProviderOne are

hyperlinks that will send you to a sub-

screen for the selected information. Update Provider Data Page/ Locations

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Step 2: Locations

Next, scroll down and view the locations

addresses. There will be three distinct

addresses for each location.

Location is the physical address of the

business. If you provide a service that

requires a license that is connected to a

specific physical location, such as an

Adult Family Home, Group Home, or

Companion Home, ProviderOne will not

approve changes to

your location address.

To update this address

contact DSHS.

Mailing is the address

where ProviderOne will

send you mail.

Pay To is the address

where ProviderOne will

mail your payments.

Please note: if you have

electronic fund transfer

(EFT), this address is used as a back-up.

Note:

Providers can make changes to the

‘Mailing’ and ‘Pay-To’ address on their

own. Click on an address hyperlink to

view and modify.

Update Provider Data Page/ Locations

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Step 2: Locations

Update Provider Data Page/ Manage Provider Locations

Once you have selected an address to update, the ‘Manage Provider Locations’ page appears. From there, do the following:

Click Address Type

Click on Address hyperlink (shown on previous pg.) to edit or change address

Enter new address

Enter zip code

Validate address

Click on Address Note: Greyed out text cannot be modified.

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Step 2: Locations


Clicking on Address will open the ’Address Details’ page. Here, you will confirm the address information entered and then click Validate Ad-

dress. The address will be validated against Post Office information. Once confirmed, click ’OK’.

You can then return to the ‘View/Update Provider Data’ page’ and submit these changes for review.

Note:

If the Validate Address button re-

sults in an invalid address, you can

still enter the address you want to

use. The Validate Address button

simply checks to see if it matches

Post Office records and does not

prohibit non-matches.

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Step 2: Locations


Returning to the ‘Location Details’ screen, scroll down to the ‘Address List’. To view new address:

Select Status from the drop down menu,

Enter “%” in search field,

Click on Go.

The new address will be shown with ‘In Review’ as the new status. Select ‘Save’

and ‘Close’.

You will return to the ‘View/Update Provider Data’ page and can now submit

these changes for review. Repeat process for each location. (where applicable)

Note:

In ProviderOne, the ‘%’ works as a wildcard and will re-

turn any information that corresponds with the current

search.

For example, if searching for multiple location authori-

zations (auth screen), enter the 7 digit domain and add

the ‘%’ to the end.

This will return all authorizations for every location un-

der the chosen domain

In Review

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Step 8: Contract Details

Update Provider Data Page/ Contract Details

Viewing contract details can be done in ProviderOne.

From the View/Update Provider Data page click on Step 8: Contract

Details. The ‘Contracts List’ page appears.

Check the ‘End Date’ and ‘Status’ of your contract.

Note:

If your contract is within 2 months of expiration or has

expired, contact the DSHS contact listed on page 1 of

your contract.

You may see errors on authorizations until the contract

information has been updated.

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Step 15: Payment & Remittance Details

Update Provider Data Page/ Payment & Remittance Details

Each location can have the

same, or different payment op-

tions and details.

View and/or change the paya-

ble information for each of your

locations.

Click Step 15: Payment & Re-

mittance Details from the ‘View/

Update Provider Data’ page.

Select a location hyperlink.

Note:

Remittance Advice (RA) is linked to a location and so

will include only the payment details for a single loca-

tion. Each location will have its own RA.

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Once you have chosen a location, the ‘Provider

Information’ pop-up appears.

Review the payment details. Make any

changes in the ‘Financial Institution

Information’ fields.

ProviderOne is defaulted to send out paper

checks (warrants) unless otherwise

designated.

Electronic Funds Transfer (EFT, Direct

Deposit) is also available.

Receiving payments directly to the bank is

fast, safe and reduces the occurrences of

lost or late payments.

To change payment to Electronic Funds

Transfer (EFT, Direct Deposit), click on

the Electronic Fund Transfer radio button.

Note: You must also fill out an EFT form

12-0004, available from the Washington

State Health Care Authority. (HCA)

https://www.hca.wa.gov/assets/billers-and-providers/

electronic-funds-transfer-form.doc

Instructions can be found here https://www.hca.wa.gov/

assets/electronic-funds-transfer-form-instructions.pdf

https://www.hca.wa.gov/assets/billers-and-providers/electronic-funds-transfer-form.doc

https://www.hca.wa.gov/assets/billers-and-providers/electronic-funds-transfer-form.doc

https://www.hca.wa.gov/assets/electronic-funds-transfer-form-instructions.pdf

https://www.hca.wa.gov/assets/electronic-funds-transfer-form-instructions.pdf

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When changing to EFT,

make sure to do the follow-

ing:

Select the EFT radio

button,

Under ‘Submission Infor-

mation’, verify ‘Reason

for Submission’ is

Change Enrollment,

Enter name which repre-

sents an ‘Authorized Signa-

ture’,

Click on ‘OK’

If you did not make

any changes to the

page, Click on

‘Cancel’

Repeat process for each

location and submit

changes for review.

Note:

There is a delay of ten business days before

modifications may take effect.

During this period, payments will be issued to

the “Pay To” address for the location.

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