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Chapter 182-502 WAC

Last Update: 2/27/14

ADMINISTRATION OF MEDICAL PROGRAMS—PROVIDERS

WAC Sections

PROVIDER TYPES
Eligible provider types.
Noneligible provider types.
ENROLLMENT
Core provider agreement (CPA).
Enrollment for nonbilling individual providers.
When the medicaid agency enrolls.
When the medicaid agency does not enroll.
Review and consideration of an applicant's history.
PROVIDER REQUIREMENTS
Continuing requirements.
Change of ownership.
Health care record requirements.
Provider preventable conditions (PPCs)—Payment policy.
Electronic health records (EHR) incentive program.
TERMINATION OF PROVIDER
Termination of a provider agreement—For cause.
Termination of a provider agreement—For convenience.
INFORMAL DISPUTE RESOLUTION PROCESS
Provider dispute of an agency action.
REAPPLYING FOR PARTICIPATION
Reapplying for participation.
PAYMENT
General conditions of payment.
Conditions of payment—Medicare deductible and coinsurance.
Payment for health care services provided outside the state of Washington.
INTEREST PENALTIES
Interest penalties—Providers.
TIME LIMITS FOR BILLING
Time limits for providers to bill the department.
BILLING A CLIENT
Billing a client.
PROVIDER REPORTS
Statistical data-provider reports.
APPEAL—RATE REIMBURSEMENT
Administrative appeal contractor/provider rate reimbursement.
PROVIDER PAYMENT REVIEWS AND DISPUTE RIGHTS
Provider payment reviews and dispute rights.
Appeals and dispute resolution for providers with contracts other than core provider agreements.
Review of agency's provider dispute decision.