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  • Wa Hca 13-879 2017

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Rovider for healthcare service(s) that the Health Care Authority (HCA) will not pay. Both parties must sign this Agreement. For the purposes of this Agreement, services include but are not limited to healthcare treatment, equipment, supplies, and medications Client - A recipient of Medicaid or other healthcare benefits through the HCA or a managed care organization (MCO) that contracts with the HCA. Provider - An institution, agency, business, or person that provides healthcare services to.

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Related content

Agreement to pay for healthcare services
HCA 13-879 (7/17) ... Both the provider and the client must fully complete this form...
Learn more
Wash. Admin. Code § 182-502-0160 - Billing a...
The client and provider must sign and date the HCA form 13-879, Agreement to Pay for...
Learn more
PROVIDER MANUAL Molina Healthcare of Washington...
Jan 1, 2021 — Member and the provider both sign Health Care Authority form 13-879...
Learn more

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Medicaid. Original claims: The claim must be received by Kaiser Permanente within 12 months from the date of services. Adjustment requests: The request must be received within 24 months from the date the claim was processed (RCW 48.43.

Medicaid does not pay money to you. It sends payments directly to your health care providers. Medicaid can pay for medical services in your own home or if you live in a residential care facility that takes Medicaid residents. Learn more about how to apply for Medicaid.

Your Rights and Protections Against Surprise Medical Bills. Beginning January 1, 2020, Washington State law protects you from surprise, or balance, billing. Under your health plan, you're responsible for certain cost-sharing amounts. This includes copayments, coinsurance, and deductibles.

Payer Name: Medicaid - Washington|Payer ID: MC006|Professional (CMS1500)/Institutional (UB04)[Hospitals]

It is illegal for a provider to bill a Medicaid recipient. It is your responsibility to verify coverage. You cannot charge me even if Medicaid does not pay. WAC 388-502-0160 (1).

To comply with provisions of the Affordable Care Act (ACA) regarding enrollment and screening of providers (Code of Federal Regulations: 42CFR, §455.410 Opens a new window), all providers MUST be enrolled in the Pennsylvania State Medicaid program before a payment of a Medicaid claim can be made.

ProviderOne is the computer system that coordinates with the health plans. It also sends you letters and handbooks. The number on the card is your ProviderOne client number.

Medicaid will not pay for services of a provider who has not registered in the Medicaid program. Providers are not required to participate in the Medicaid program. If they do, they must accept all Medicaid recipients as patients.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232