Chapter 182-502 WAC

Last Update: 5/30/24

ADMINISTRATION OF MEDICAL PROGRAMS—PROVIDERS

WAC Sections

PROVIDER TYPES
HTMLPDF182-502-0002Eligible provider types.
HTMLPDF182-502-0003Noneligible provider types.
ENROLLMENT
HTMLPDF182-502-0005Core provider agreement (CPA).
HTMLPDF182-502-0006Enrollment for nonbilling individual providers.
HTMLPDF182-502-0010When the medicaid agency enrolls.
HTMLPDF182-502-0012When the medicaid agency does not enroll.
HTMLPDF182-502-0014Review and consideration of an applicant's history.
PROVIDER REQUIREMENTS
HTMLPDF182-502-0016Continuing requirements.
HTMLPDF182-502-0017Employee education about false claims recovery.
HTMLPDF182-502-0018Change of ownership.
HTMLPDF182-502-0020Health care record requirements.
HTMLPDF182-502-0022Provider preventable conditions (PPCs)—Payment policy.
HTMLPDF182-502-0025Electronic health records (EHR) incentive program.
TERMINATION OF PROVIDER
HTMLPDF182-502-0030Termination of provider enrollment—For cause.
HTMLPDF182-502-0040Termination of a provider agreement—For convenience.
INFORMAL DISPUTE RESOLUTION PROCESS
HTMLPDF182-502-0050Provider dispute of an agency action.
REAPPLYING FOR PARTICIPATION
HTMLPDF182-502-0060Reapplying for participation.
PAYMENT
HTMLPDF182-502-0100General conditions of payment.
HTMLPDF182-502-0110Conditions of payment and prior authorization requirements—Medicare coinsurance, copayments, and deductibles.
HTMLPDF182-502-0120Payment for health care services provided outside the state of Washington.
INTEREST PENALTIES
HTMLPDF182-502-0130Interest penalties—Providers.
TIME LIMITS FOR BILLING
HTMLPDF182-502-0150Time limits for providers to bill the agency.
BILLING A CLIENT
HTMLPDF182-502-0160Billing a client.
PROVIDER REPORTS
HTMLPDF182-502-0210Statistical data-provider reports.
APPEAL—RATE REIMBURSEMENT
HTMLPDF182-502-0220Administrative appeal contractor or provider rate reimbursement.
PROVIDER PAYMENT REVIEWS AND DISPUTE RIGHTS
HTMLPDF182-502-0230Provider overpayment disputes—General.
HTMLPDF182-502-0260Appeals and dispute resolution for providers with contracts other than core provider agreements.
HTMLPDF182-502-0270Review of agency's provider dispute decision.