A full list of the current preapproved sites is below. Important: Make sure the attestation date on your provider application is the following completed documents: Youll receive a confirmation email from Premera that says weve received your request. Olympia, WA 98504-7877. Below are some standardized tools that the WCSG has developed over the years that are accepted by most organizations around the state. A Release of Information is a vital component to credentialing applications. If your submitted application is accepted: For all Premera plans, you can't see members until you're officially credentialed under contract. Credentialing ) or https:// means youve safely connected to the .gov website. PDF Department of Labor and Industries If you've missed the deadline to renew, but you would like to continue coverage, please contact us as soon as possible. CONTACT US OneHealthPort manages your user credentials and Medversant hosts the ProviderSource site and application. The fastest way to renew your lost coverage is to go online. If you have any questions on accessing the CAQH Provider Data Portal database , just call the CAQH Help Desk at 888-599-1771 for assistance. Expedited licensure through the Interstate Medical Licensure Compact Commission (IMLCC) Uniform Application through the Federation of State Medical Boards (FSMB) You can view all options and forms on this . If you do not have access to email,you may also leave a voice message at 360-236-2750. The group or facility under which you practice must be enrolled with HCA as a billing provider and have a Core Provider Agreement with the agency. If you have further questions about application status or licensing, contact our call center at 360-236-4700 or by email or by mail: Department of Health. The Washington State Department of Health presents this information as a service to the public. Online: Go to Washington Healthplanfinder - select the "Apply Now" button. If you need to submit a credentialing application, you can currently utilize the following options: Before applying, check the Washington network closure matrix to see which counties are open to accepting new providers. More information can be found in the Adult Vaccine Program User Manual . Enroll as a health care professional practicing under a group or Dates of birth for each member of your household. Privacy Policy| Alternate Format Requests | Notice of Nondiscrimination, File Complaint About Provider or Facility, Healthcare Enforcement and Licensing Modernization Solution, Healthcare Professional Credentialing Requirements, Veterans, Service Members and their Families, Emergency Information for Specific Groups, Lactation and Infant Feeding-Friendly Environments, Public Health System Resources and Services, View current application processing times, Centers for Disease Control and Prevention (CDC), Local Health Jurisdictions and Tribal Directories, Northwest Center for Public Health Practice, Conducting state and national background checks, Assuring applicants meet all educational, clinical and profession-specific requirements, Assessing each application for military training and experience, Coordinating with state agencies, boards and commissions and secretary-regulated programs, Providing technical assistance to the public and applicants; and. An official website of the U.S. Department of Homeland Security, Telos Corporation becomes TSAs second official TSA PreCheck enrollment provider. Service contract provider application (PDF, 1.65 MB) Service of legal process form (PDF, 660.60 KB) Also, your malpractice insurance must not expire before credentialing is complete. Request an individual contract or join one of our contracted independent practice associations or medical groups. Important! Please return all applications to: Department of Health. Apply for or renew your Apple Health coverage online through Washington Healthplanfinder if you are: You have several options to apply for or renew coverage: If youre accepted, you'll receive a ProviderOne services card in about two weeks. Helps income-eligible apprentices pay for tuition, fees, and materials. Each year, a completed provider agreement is required prior to the receipt of publicly supplied vaccine. Federally-funded program providing services to low-income schools, Archive of Council updates and news releases, Archive of reports and publications regarding financial aid, policy, and research, plus statewide strategic planning, Archive of published materials from Council communications, Washington College Grant for Apprenticeship, Washington Award for Vocational Excellence (WAVE), State Authorization Reciprocity Agreement (SARA), WHC Program Comparison & Eligible Professions, https://portal.wsac.wa.gov/a/health-apps/. English (Word) English (PDF) 15-093. English (Word) English (PDF) 15-209A. Servicing provider applications submitted without a billing provider will be denied. Availity is solely responsible for its products and services. WSAC reviews site applications and posts a list of the preapproved sites. The company will continue to expand enrollment services nationally, offering new convenient locations with expanded hours of operation. If you have questions, we recommend emailing Medical.Licensing@wmc.wa.gov. Step 2:Providers apply during the provider application cycle. HIPAA covered entity healthcare providers must provide an NPI (National Provider Identifier) when applying. For providers in Washington: You will begin the credentialing process by registering with OneHealthPort ProviderSource. Once the roster spreadsheet has been filled out, follow the instructions for roster file upload and reviewing roster errorsto upload the roster and resolve errors. Washington Apple Health | Washington Healthplanfinder The presence of information in this system doesn't imply a provider isn't competent or qualified to practice. | Olympia, WA 98504-7877. ProviderOne Security assigns confidential login credentials to the person named on the form as the provider system administrator. Apply for Apple Health Classic Medicaid coverage online through Washington Connection if you are: You have several options to apply for or renew Classic Medicaid coverage: If you're found eligible for coverage, you'll receive a ProviderOne services card in about two weeks. Mobile app: Download the WAPlanfinder app - select "sign in" or "create an account". Developing credentialing data systems and processes for new healthcare professions as mandated by law. If you're unable to submit through ProviderSource, use our hard-copy credentialing application. Licenses, Permits & Certificates - Washington State Department of Health Dental provider application - Request to join our dental network Contact Michelle Pittman and Lisa VelottaLisa.Velotta@usfhppacmed.org, Washington Association Medical Staff Services, Washington Credentialing Standardization Group (WCSG), Managed Behavioral Health Care Organization. The application fee for 2023 is $688. Kaiser Permanente Washington regularly updates this information with available contract positions for our Core Plan, PPO Plan, Alternative Medicine Providers, Pharmacies, and Delegated Provider Groups. However provider-specific documents may be required depending on your provider type. Italiano | ProviderSource is a service to help Washington healthcare providers manage provider data used for credentialing and privileging. License Renewals | Washington State Department of Health In either case, you must meet our credentialing standards and criteria. Step 1: Sites apply and request preapproval status. Join Our Network | Provider | Premera Blue Cross Medversant is currently working to resolve the issue. "EXT Provider File Maintenance" or "EXT Provider Super User" for the profile. Guidance for Clock Hour Providers. Licensing | Washington Medical Commission Apple Health (Medicaid) biller or provider 1.800.562.3022 (choose "provider services") The DOH, Health Systems Quality Assurance response to the novel Coronavirus (COVID-19) outbreak may delay our ability to process paper licensure applications submitted through the USPS. Join Our Network - Amerigroup The information on this site comes directly from our database and is updated daily. This site provides true and correct copies of legal disciplinary actions taken after July 1998, unless prohibited by law. 3. Share sensitive information only on official, secure websites. Telos began enrolling its first applicants during trial periods in Annapolis, Md., Chantilly, Va., Ashburn, Va. and Las Vegas. We update the application every couple of years, so submit your change request to the WCSG ChairCarrianne Dockter and well add it to the list of revisions to consider. Recredentialing You must be recredentialed every three years. The Credentialing Section ensures all applicants meet established professional qualifications and requirements in accordance with the Revised Code of Washington (RCW) and the Washington Administrative Code (WAC) before a credential is issued. instructions for adding Billing Type and Available Agencies, roster instructions for HCA providers only, instructions for roster file upload and reviewing roster errors, Apple Health for Workers with Disabilities (HWD), Medically Intensive Children's Program (MICP), Behavioral health services for prenatal, children & young adults, Wraparound with Intensive Services (WISe), Behavioral health services for American Indians & Alaska Natives (AI/AN), Substance use disorder prevention & mental health promotion, Introduction overview for general eligibility, General eligibility requirements that apply to all Apple Health programs, Modified Adjusted Gross Income (MAGI) based programs manual, Long-term services & supports (LTSS) manual, Medical plans & benefits (including vision), Life, home, auto, AD&D, LTD, FSA, & DCAP benefits.