Washington Alliance
for Quality Recovery Residences
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Welcome to our Quick Guide for nonbilling providers aspiring to become FCS Providers and secure Medicaid reimbursement for Recovery Residences in the state of Washington.
If you're on a journey to enhance your Recovery Residence and navigate program start up, you're in the right place. Let this serve as a guide designed to assist you through the process, providing valuable insights and step-by-step instructions.
Dive into our user-friendly guide to streamline the path towards becoming an FCS Provider and elevating the quality of care you offer in the state of Washington.
Phase 1
Application Process
Click on Steps 1, 2, or 3 for quick access to resources and helpful information.
To receive a OneHealthPort Subscriber ID, your healthcare organization must register with OneHealthPort.
Step 1:
Obtain National Provider Identification Number (NPI)
A National Provider Identifier is a unique 10-digit identification number issued to health care providers.
Registered User: the system requires a designated administrator to set up an account with their personal information.
Information you will need.
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First & Last Name
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Business Phone
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DOB
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SSN
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Personal Phone
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Home Address
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City
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Country
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State / Province / Territory
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Zip Code
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When you go to this page you find information on
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ProviderOne access (how to access ProviderOne)
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Reimbursement Information
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Resident Elgibility
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Enrollment Application for Non-billing Provider (to start the process)
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FCS Provider One Enrollment (Gives instructions how to enroll and what to select
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Tips and Good Things to Know
You will receive an email from Wellpoint giving you your Provider One/Medicaid ID number, and describing your next steps. KEEP IN MIND, they may be duplicative actions of the steps you previously taken.
Contact Wellpoint to begin contracting and getting set up for billing.
Step 4:
OneHealthPort (OHP)
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Each Organization must designate a OneHealthPort Administrator.
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This person will complete the registration process and will manage the Organization's account.
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The OneHealthPort Administrator will register online at OneHealthPort Registration
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Once these steps have been completed, the Administrator will receive notification within 72 hours that the Organization and individual credential have been activated
Phase 2
2
Email the FCS Manager, Foundational Community Supports (FCS), Connor Chin
- Prior to accessing Availity you will need to establish a process to log and track services to enter those services into Availity.
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Tip 1 make sure you document and track everything that you load into availity.
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Tip 2: Make sure all the Notes are worded correctly and use the specific phases listed in Activities list.
Implementation and Program Management
Service Reimbursement
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Talk to Connor Chin
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Prior to accessing Availity you will need to establish a process to log and track services in order to enter those services into Availity.
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Audits and Compliance
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Tip 1 make sure you document and track everything that you load into availity.
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Tip 2: Make sure all the Notes are worded correctly and use the specific phases listed in Activities list.
Here's some helpful information that will help you establish a process and enter the claims.
Once you enter the Claims and Payment section of Availity you will enter the
User the clients provider 1 number for the subscriber ID and indicate yes for authorized plan for payment.
You will also need to complete the billing providers information...
Express ... auto populates
FCS Service Log – Entries are entered by client
Client Name
Service Category
Diagnosis Code
HCPCS Code
Duration
Services entered in tortal for each client
Service categories are documented in your note and details reflect both activity and justify duration for audit purposes
See note below
Based on services delivered, see note below
Units of time in total for all services using the same HCPCS code
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Document and Track Service Categories
Service definitions and examples begin on page 10 of the Amerigroup provider manual for supportive housing Services and on page 13 for Supportive Employment services.
Define the activity (for detailed descriptions of the activities visit the FCS service Manual.
Examples of approved activites:
The documentation should reflect and support the duration of each activity provided.
Supportive Housing Services H0043
Service Categories:
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Community Support Services – see attached for activities to include in documentation note (staff training)
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Pre-Tenancy Supports – see attached for activities to include in documentation note (staff training)
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(ACTIVITES)
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Needs assessment
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Connection to services
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Housing application
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Community integration plan
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Goal setting
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Plan development meetings
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Supportive interventions
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Tenancy Sustaining Services – see attached for activities to include in documentation note (staff training)
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(ACTIVITES)
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Service planning support
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Plan meetings
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Supportive interventions
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Supported Employment
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(H2023) Pre-employment services
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(H2025) Employment-sustaining services
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Service Categories:
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Individual Placement Support Services
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Pre-employment services
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(ACTIVITES)
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Job assessment
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Employment planning
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Job development and placement services
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Job carving
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Benefits education and planning
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Transportation but can only be included with above service (documented time and justification in note with correlated service
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Employment sustaining services
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(ACTIVITES)
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Career advancement services
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Negotiation with employer on job accommodations
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Job coaching
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Benefits and education planning
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Transportation but can only be included with above service (documented time and justification in note with correlated service
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Asset development
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Follow along support
Training & Helpful Documents
Here are some resources that are helpful for when ready and available to implement.
Generic Staff Time (how to track service hours/staffing)
FCS Simple Budget
FCS Time Study (tool to use for documentation and reimbursement)
FCS Capacity & Outcomes Report
Policy & Procedures
Contact HCA for guidance on program and policies and contact Wellpoint for billing and reimbursement.