Oct
15
2024
Discovery log number
00430
Discovery description
This week's (October 10, 2024) ProviderOne payment is delayed for some Social Services Providers. The Health Care Authority (HCA) has informed the Department of Social & Health Services (DSHS) that there is a delay for this week's ProviderOne payment cycle, affecting some Social Services Providers. There are approximately 465 total providers who submitted claims by 10/8/2024 who are affected.
The expectation is that electronic funds transfer (EFT) payments and paper checks will be sent on Monday, 10/14/2024. The payments sent out on 10/14/2024 will be on the Remittance Advice (RA) dated 10/18/2024. If you have questions about this or do not receive payment when expected, please contact HCA's Medical Assistance Customer Service Center (MACSC) via phone at 800-562-3022 (choose "provider services") or via webform. We apologize for any inconvenience.
Date reported
ETA
Provider impact
All Providers
Workaround
Please report any issues to: mmishelp@hca.wa.gov
Date closed
Academic Learning Collaborative
The Academic Learning Collaborative (ALC) is a research initiative connecting academic organizations across the state. The ALC advances knowledge by supporting evidence-based health care and cultivating a statewide research community. Learn more about the ALC and how to get involved.
Interested in getting involved with the ALC? Fill out the ALC application!
The Academic Learning Collaborative (ALC) provides multiple ways to get involved. Researchers are welcome to participate in the ALC if research priorities are of shared interest with HCA. Participation involves:
- Attendance at the annual Academic Learning Collaborative Symposium.
- Ad hoc meetings and correspondence facilitated by HCA that may include:
- Discussion on topics of interest.
- Information sharing on sources of funding for research projects.
- Information sharing on ways to access data.
Participants may be able to receive additional support, depending on availability.
How to apply to the ALC
- Download and complete the application.
- Email the application to the HCA Academic Learning Collaborative.
Applications will be reviewed on a rolling basis. There is no cost for membership. Requests for funding or other support will be considered according to the schedule below and includes ALC membership:
|
Application type |
Reviewed |
|---|---|
|
APCD scholarships and fee reduction requests |
As needed |
|
Grant co-applicant |
As needed |
|
Grant application support |
As needed |
|
Drawing federal match on a funded request |
Quarterly |
|
Direct funding |
Semi-annually |
All support recipients are required to present their research as it relates to health care in Washington State at the annual HCA ALC Symposium each fall. Other ALC members are invited to participate in the symposium, but are not required to do so.
Discovery log number
00429
Discovery description
Previously entered filter criteria data is retained when the user clicks on the Submit Another Inquiry or Exit button. This is affecting state staff and providers. in pgProvMedicaid page in provider portal.
Date reported
ETA
Provider impact
All Providers
Workaround
The work around is to have the user remove the previous search criteria before submitting the next Benefit Inquiry eligibility check.
Compare vision plans
Find out about PEBB vision plans available to you and your dependents. You and any enrolled dependents must be enrolled in the same PEBB vision plan.
Before you select a vision plan, call the plan to see if your vision provider is in the plan's network.
On this page
How do the vision plans compare?
Before you enroll in a vision plan, use the Vision Benefits At-a-Glance Comparison to get the details you need to help you decide.
For information on specific benefits and exclusions, review the plan's certificate of coverage (COC) or call the plan.
What does a vision plan cover?
Vision plans cover:
- An eye exam (once every year)
- A set of lenses (Benefit resets every January 1 of odd years)
Vision plans give an allowance toward new frames or contacts (in lieu of glasses) every January 1 of odd years (2025, 2027, etc.)
Some plans may also include discounts on laser vision correction, or LASIK.
Does my medical plan cover vision?
Your medical plan covers general eye health.
If you have an eye problem that’s related to a medical condition, such as cataracts, diabetes, or an injury, then your medical plan will more than likely cover you. These types of claims would fall under medical insurance; whereas a vision exam and glasses would fall under vision insurance.
For example: If your eye doctor was fitting you for contact lenses and discovered a torn retina, your medical plan would cover further exams and visits until it was resolved. A torn retina is a medical problem, not a vision correction issue.
What providers can I see?
Before you select a vision plan, call the plan to see if your vision provider is in the plan's network.
Davis Vision by MetLife
Visit Davis Vision by MetLife's provider search.
EyeMed
Visit EyeMed's provider search.
MetLife Vision
Visit MetLife Vision's provider search.
Preauthorization criteria
Preauthorization is when you seek approval from your health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that your plan will pay for those services, supplies, or drugs.
These criteria do not imply or guarantee approval. Please check with your plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.
Compare vision plans
Find out about PEBB vision plans available to you and your dependents. You and any enrolled dependents must be enrolled in the same PEBB vision plan.
Before you select a vision plan, call the plan to see if your vision provider is in the plan's network.
On this page
How do the vision plans compare?
Before you enroll in a vision plan, use the Vision Benefits At-a-Glance Comparison to get the details you need to help you decide.
For information on specific benefits and exclusions, review the plan's certificate of coverage (COC) or call the plan.
What does a vision plan cover?
Vision plans cover:
- An eye exam (once every year)
- A set of lenses (Benefit resets every January 1 of odd years)
Vision plans give an allowance toward new frames or contacts (in lieu of glasses) every January 1 of odd years (2025, 2027, etc.)
Some plans may also include discounts on laser vision correction, or LASIK.
Does my medical plan cover vision?
Your medical plan covers general eye health.
If you have an eye problem that’s related to a medical condition, such as cataracts, diabetes, or an injury, then your medical plan will more than likely cover you. These types of claims would fall under medical insurance; whereas a vision exam and glasses would fall under vision insurance.
For example: If your eye doctor was fitting you for contact lenses and discovered a torn retina, your medical plan would cover further exams and visits until it was resolved. A torn retina is a medical problem, not a vision correction issue.
What providers can I see?
Before you select a vision plan, call the plan to see if your vision provider is in the plan's network.
Davis Vision by MetLife
Visit Davis Vision by MetLife's provider search.
EyeMed
Visit EyeMed's provider search.
MetLife Vision
Visit MetLife Vision's provider search.
Preauthorization criteria
Preauthorization is when you seek approval from your health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that your plan will pay for those services, supplies, or drugs.
These criteria do not imply or guarantee approval. Please check with your plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.
Discovery log number
00428
Discovery description
ProviderOne has identified a small set of providers affected by a remittance advice issue that occurred on September 5-6, 2024. A Mass Adjustment of the impacted claims will be completed to ensure all financial aspects used in reconciling accounts are connected back to the original Transaction Control Numbers (TCNs) on the unbalanced remittance advice. A message will be placed on the identified providers' remittance advices to inform them that the Mass Adjustment is complete. If you do NOT see a message on your Remittance Advice, you are not one of the providers impacted by this issue. For those providers impacted by this issue, if you have additional questions, please submit a ProviderOne help request to mmishelp@hca.wa.gov.
Date reported
ETA
Provider impact
All Providers
Workaround
Please report any issues to: mmishelp@hca.wa.gov.
Date closed