ProviderOne Adjustments Update

On July 2, WHCA representatives met with DSHS regarding the announcement that the Washington Health Care Authority will be making remittance adjustments to home and community-based care providers who received inaccurate payments for services. Resident participation amounts did not sync with payments for 2500+ claims from the period of April 2023 through April 2024. Based on initial review, the Department does not expect significant repayments, however, real impact will not be known until the mass adjustment is completed in mid-July. Once adjusted, providers will receive a notice from the Office of Financial Recovery regarding overpayment amounts, and then will have 28 days to appeal or reimburse the OFR for overpayments. If you have questions or need additional information about this adjustment, please email [email protected] for assistance.

As a reminder, ProviderOne must have accurate provider contact information if you are to receive information about such issues. You must update that information.  Click here for the ProviderOne billing guide, which will provide details about managing your account.