WSPA handout 071609 by o9S16v4


									3 Steps to Readiness
How do Pharmacies Get Ready for the Next ProviderOne Implementation?
The next stage of ProviderOne implementation is scheduled for December 6, 2009. You may recall that DSHS transitioned to the
ProviderOne Pharmacy Claims engine in October 2008. With the October implementation, DSHS implemented a new ProviderOne
Pharmacy Claims engine while keeping the old legacy mainframe at the back end. The next stage of ProviderOne replaces the
legacy back end system with the new ProviderOne back end system. There are 3 steps that Pharmacies need to take prior to the
next implementation in December in order to make sure you continue to get paid.

DSHS recommends that you complete these steps as follows (see web links and other useful information on the next page):
  1) Security: DSHS recommends that you obtain a user name and password no later than August 15, 2009. You will need access
      to ProviderOne to register, maintain your provider file, check eligibility, lookup new ProviderOne client IDs, and access
      remittance advice.
  2) Registration: Once you obtain your user name and password, DSHS recommends that you log on to ProviderOne and review
      your provider file currently loaded in ProviderOne to ensure it is accurate and was converted from the old back-end system
      correctly. You should verify information on where your payments will be sent. DSHS recommends you complete this step no
      later than September 15th.
  3) New Client ID: Pharmacy claims processed beginning December 6, 2009 must include the new ProviderOne client ID instead
      of the current Patient Identification Code (PIC). You should be making plans to accommodate this change. DSHS has created
      a crosswalk that maps the current PIC to the new ProviderOne client ID.

Why should pharmacies complete these readiness steps?
Pharmacies need to complete these steps to continue to get paid after December 6, 2009. There are also several benefits coming
with the next implementation of ProviderOne. These benefits include:
   1) Real time benefit information and eligibility checks
   2) Smart prior authorizations reducing the need for phone calls
   3) Electronic submission of non- pharmacy claims (durable medical equipment, vaccinations, etc.)
   4) New tools with Coordination of Benefits COB) and more coming in 2010
How do pharmacies get help with these readiness steps?

1) Security
   Go to our Security Web page ( for general information on security. For the details:

      DSHS ProviderOne Provider Registration and Security Administration Manual
      Obtain security credentials at
      Using the Security Spreadsheet (for larger organizations): Instructions are at and you can link to the spreadsheet
      Basic Security Profiles
        Provider System Administrator
        Provider Eligibility Checker
        Provider File Maintenance
        Provider Claims/Payment Status Checker

   If you have security questions or login issues, e-mail, or call 1-800-562-3022 (select options 2, 4, 1).

2) Registration
    Refer to the DSHS ProviderOne Provider Registration and Security Manual at
    For the Registration Checklist, go to
    For specific Pharmacy steps, see our Pharmacy POS information at

   For questions about the Registration process, changing an NCPDP or Tax ID number, e-mail, or call
   1-800-562-3022 (select options 2, 4, 2).

3) PIC-to-Client ID Crosswalk
    Crosswalk will contain PICs and new Client ID numbers for clients you have served in the past 24 months.
    You can test the crosswalk tool now (, but must download a new, current version
     within the 30 days before go-live.
    Download a crosswalk for each MMIS ID number in your organization.
     Visit our ProviderOne Pharmacy POS readiness page at

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