Section 182-537-0600. School district requirements for billing and payment.  


Latest version.
  • To receive payment from the medicaid agency for providing school-based health care services (SBHS) to eligible children, a school district must:
    (1) Have a current, signed core provider agreement (CPA) with the agency.
    (2) Have a current, signed, and executed interagency agreement with the agency.
    (3) Meet the applicable requirements in chapter 182-502 WAC.
    (4) Comply with the agency's current, published ProviderOne billing and resource guide.
    (5) Bill according to the agency's current school-based health care services provider guide, the school-based health care services fee schedule, and the intergovernmental transfer (IGT) process. After a school district receives its invoice from the agency, the district must provide its local match to the agency within one hundred twenty days.
    (6) Provide only health care-related services identified through a current IEP or IFSP.
    (7) Use only health care professionals qualified under WAC 182-537-0350.
    (8) Enroll servicing providers under the school district's national provider identifier (NPI) number, and ensure providers have their own NPI number.
    (9) Meet documentation requirements in WAC 182-537-0700.
    [Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 16-07-141, § 182-537-0600, filed 3/23/16, effective 4/23/16. Statutory Authority: RCW 41.05.021, 34 C.F.R. 300.154(d), and chapter 182-502 WAC. WSR 13-21-079, § 182-537-0600, filed 10/17/13, effective 11/17/13. Statutory Authority: RCW 41.05.021. WSR 13-05-017, § 182-537-0600, filed 2/7/13, effective 3/10/13. WSR 11-14-075, recodified as § 182-537-0600, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.500, and 42 C.F.R. 440.110. WSR 09-07-004, § 388-537-0600, filed 3/4/09, effective 4/4/09.]
RCW 41.05.021 and 41.05.160. WSR 16-07-141, § 182-537-0600, filed 3/23/16, effective 4/23/16. Statutory Authority: RCW 41.05.021, 34 C.F.R. 300.154(d), and chapter 182-502 WAC. WSR 13-21-079, § 182-537-0600, filed 10/17/13, effective 11/17/13. Statutory Authority: RCW 41.05.021. WSR 13-05-017, § 182-537-0600, filed 2/7/13, effective 3/10/13. WSR 11-14-075, recodified as § 182-537-0600, filed 6/30/11, effective 7/1/11. Statutory Authority: RCW 74.08.090, 74.09.500, and 42 C.F.R. 440.110. WSR 09-07-004, § 388-537-0600, filed 3/4/09, effective 4/4/09.

Rules

182-502,182-537-0350,182-537-0700,