INTERPRETIVE OR POLICY STATEMENT
SOCIAL AND HEALTH SERVICES
Subject: Healthy Options/Basic Health Plus/Children's Health Insurance instructions for supplemental billing.
Effective Date: October 2003.
Document Description: These are billing instructions are for HO/BH+/CHIP health care plans to use when billing for supplemental services for managed care clients. Included in this document are definitions, purpose of program, billable services, billing information, fee schedule, and how to complete the HCFA-1500 claim form.
To receive a copy of the interpretive or policy statement, contact Kevin Sullivan, Regulatory Improvement Coordinator, Department of Social and Health Services, Medical Assistance Administration, Division of Program Support, P.O. Box 45533, Olympia, WA 98504, phone (360) 725-1344 or go to website http://maa.dshs.wa.gov (click on Billing Instructions link), TDD 1-800-848-5429, fax (360) 586-9727, e-mail mailto:firstname.lastname@example.org.
September 11, 2003
E. A. Myers, Manager
Rules and Publications Section