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Page 1: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 2: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 3: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 4: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/billers-providers-partners/prior-authorization-claims-and-billing/prior-authorization-pa
Page 5: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 6: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 7: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 8: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 9: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 10: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 11: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 12: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/billers-and-providers/Tribal-health-bi-20180401.pdf
Page 13: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 14: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 15: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/about-hca/tribal-affairs
Page 16: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/billers-and-providers/EPSDT-bi-20180401.pdf
Page 17: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/billers-and-providers/physician-related-serv-bi-20180825.pdf
Page 18: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/tribal-tcow-2018-08-08.pdf
https://www.hca.wa.gov/assets/billers-and-providers/Tribal-health-bi-20180401.pdf
Page 19: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/billers-and-providers/Dental-related-serv-bi-20180701.pdf
https://www.hca.wa.gov/assets/13-809.doc
Page 20: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 21: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/tribal-cow-091416.pdf
Page 22: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/encounter_def_state_plan_092117.pdf
https://www.hca.wa.gov/assets/tribal-tcow-2018-08-08.pdf
https://www.hca.wa.gov/assets/billers-and-providers/FQHC-bi-20180701.pdf
mailto:[email protected]
Page 23: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 24: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/billers-and-providers/Dental-related-serv-bi-20180701.pdf
Page 25: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 26: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 27: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 28: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/encounter_def_state_plan_092117.pdf
Page 29: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 30: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 31: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 32: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/tribal-tcow-2018-02-14.pdf
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=2ahUKEwimuqnph7HdAhUaIjQIHfloAL8QFjAAegQIBhAC&url=https%3A%2F%2Fwww.medicaid.gov%2Fmedicaid%2Fprogram-integrity%2Fncci%2Findex.html&usg=AOvVaw0gLsjUZ1G0KvnIPEOCYjaH
Page 33: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 34: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 35: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/billers-and-providers/physician-related-serv-bi-20180825.pdf
Page 36: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
http://apps2.leg.wa.gov/billsummary?BillNumber=1358&Year=2017&BillNumber=1358&Year=2017
Page 37: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.medicaid.gov/medicaid/program-integrity/ncci/index.html
Page 38: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 39: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
http://apps.leg.wa.gov/WAC/default.aspx?cite=182-502-0002
https://www.hca.wa.gov/assets/billers-and-providers/Vision-hardware-bi-20180701.pdf
https://www.hca.wa.gov/assets/billers-and-providers/physician-related-serv-bi-20180701.pdf
http://www.gpo.gov/fdsys/pkg/CFR-2002-title42-vol1/content-detail.html
Page 40: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 41: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/assets/billers-and-providers/mental-health-svc-bi-20180701.pdf
https://www.hca.wa.gov/assets/billers-and-providers/physician-related-serv-bi-20180701.pdf
Page 42: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.ihs.gov/portland/healthcarefacilities/
Page 43: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
http://app.leg.wa.gov/WAC/default.aspx?cite=246-809
Page 44: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
https://www.hca.wa.gov/about-hca/tribal-affairs
Page 45: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 46: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
mailto:[email protected]
mailto:[email protected]
Page 47: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 48: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 49: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 50: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 51: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 52: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 53: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
http://apps.leg.wa.gov/wac/default.aspx?cite=182-531-1730
Page 54: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 55: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 56: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
http://apps.leg.wa.gov/WAC/default.aspx?cite=182-500-0045
Page 57: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 58: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 59: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment
Page 60: Tribal Compliance and Operations Workgroup …2018/09/12  · September 12, 2018 Washington State Health Care Agenda Dental Managed Care Prior Authorization Submission Update MCO payment

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