Provider Directory

November 2021 Update

The Health Care Authority (HCA) sends you this notification to update you on our Provider Directory implementation efforts. We last notified you on May 28, 2021.

What is happening

New interoperability requirements require HCA to implement and maintain a secure, standards-based Application Programming Interface (API). HCA will make the new Provider Directory tool for Apple Health (Medicaid) clients available on December 10, 2021 through this API.

Who does this impact?

This impacts providers who are contracted with HCA, and Apple Health clients. Apple Health clients will have access to provider information as it’s displayed in the ProviderOne provider file. If provider information is not up-to-date, this will cause confusion and will increase client inquiries to provider offices.

I am an Apple Health provider. What do I need to do?

To prepare for this launch, HCA is requesting all contracted providers to update their ProviderOne provider file. Data from the ProviderOne provider file will be pulled and made available on the API.

This rule requires certain provider information such as:

Name
Address
Phone numbers
Email addresses
Specialties and sub-specialties (taxonomies)
Taking new patients (yes or no)

How do I update my information?

To update provider information you will need to take the following steps:

Find the user manual pertinent to your practice and update your practice information.
If you have more than one location enrolled under an NPI, please refer to Step 14 for each of your locations and add the providers practicing at those locations.
Update whether your location is accepting new clients. Please find the fact sheet for instructions.

Questions

If you have any questions regarding these changes or your ProviderOne provider file, please contact HCA through one of the following channels.

About the Health Care Authority (HCA)

The Washington State Health Care Authority (HCA) is committed to whole-person care, integrating physical health and behavioral health services for better results and healthier residents.

HCA purchases health care for more than 2.5 million Washington residents through Apple Health (Medicaid), the Public Employees Benefits Board (PEBB) Program, the School Employees Benefits Board (SEBB) Program, and the COFA Islander Health Care Program. As the largest health care purchaser in the state, we lead the effort to transform health care, helping ensure Washington residents have access to better health and better care at a lower cost.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.