SERI and NPI guidance documents - updated Jan. 2020
/Update 01/23/20
Message from HCA, 01/23/20
The coding subject matter experts missed a crucial error. Please see below corrected version of the SERI interim guidance document. The unit duration for the primary or parent codes should be 30 minutes rather than 15 minutes. Corrected or changed areas in the document are in red font so that they are easily seen. I’ve also attached the crosswalk we received from the APA we received as a reference document.
If you see any other errors or have questions, please email the hcamcprograms@hca.wa.gov inbox with a cc to Teresa Claycamp (teresa.claycamp@hca.wa.gov).
HCA Interim SERI Guidance 1-9-2020, Corrections 1-23-2020 - added 01/23/20
Health and Behavior 2020 crosswalk - added 01/23/20
Update 07/12/19
HCA has updated the SERI, NPI, & Taxonomies Q&A document to include many of the new questions received over the last several months around the new 7/1/2019 SERI Guide and the HCA responses to those questions.
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Update 07/05/19
HCA provided answers via email to outstanding provider questions about the new SERI guide. A formal SERI Q&A guide is expected soon.
Answers to provider SERI questions
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Update 03/18/19
HCA has released the IMC Service Encounter Reporting Instructions (SERI), with an effective date of July 1, 2019. Providers will still be able to bill under the old SERI guidelines until that date.
IMC SERI Guide
Note the hyperlinks on the procedure modifiers page are not working at this time. HCA is working to correct these links and plan to get a revised version out soon.
Please send any questions or concerns to Gail Kreiger at Gail.Kreiger@hca.wa.gov
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Important update! On Nov. 16, BHT received an important update from HCA on taxonomy codes: HCA has received a notification from clearinghouses that they cannot accept the local taxonomy codes created by HCA. See this post for more information and next steps for providers. The NPI Enrollment Fact Sheet below has been revised to reflect this update.
There have been a number of questions about Service Encounter Reporting Instructions (SERI) and enrollment of National Provider Identifiers (NPI). The HCA has created guidance documents in response to these questions from providers, linked below. The documents include appropriate contact information for providers to send questions to the HCA.
Additionally, the HCA hosted a webinar on SERI/NPI Enrollment on Oct. 5. Slides and Q&A from that webinar are below. [Note: Due to technical issues, a recording of this webinar is not available.]
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Update from HCA 12/17/18:
HCA recently released guidance regarding how to code and submit Evidence-Based Practice (EBPs) under the Integrated Managed Care (IMC) program starting January 1, 2019. See EBP Codes FAQ below.
Because HCA is allowing providers and MCOs to use the current SERI Guide for submitting encounters until July 1, 2019, there has been some confusion as to whether implementation of the IMC EBP codes rules will also be delayed until July 1, 2019.
HCA is reaching out to clarify that the new requirements for coding and submitting EBPs under IMC will become effective January 1, 2019, including the use of 9 digit EBP codes. Please make those necessary changes for January 1.
2019 IMC SERI Guide - new 3/18/19
Step-by-Step NPI Enrollment Instructions
Taxonomy Codes List in Excel Format
Minutes vs. Units FAQ & Code List
American Indian/Alaska Native (AI/AN) Fee-for-Service Checklist
American Indian/Alaska Native (AI/AN) Fee-for-Service FAQ
new! How to update an existing clinician enrollment in ProviderOne
1. Go into www.waproviderone.org as either a file maintenance or super user.
2. Go under Provider.
3. Manage Provider Information.
4. Select Step 14 servicing providers.
5. Select the name of the servicing provider you want to update.
6. Will bring up to the steps for this provider.
If you want to add a taxonomy select Step 3 and click on the add button and enter your taxonomy. Close out and go back to the steps and submit the last step to submit the modification.
You would do the same process to update clinician’s information. If just changing information you could just click on what you need to update and change the information. You do not have to select add if the information is already there. Make sure you do the last Step and submit the mod.
You can also call 1 800-562-3022 Ext .16137 and we can help walk you thru the process.
Clarification on NPI Application for Non-Resident and US Resident Aliens
Non Resident and US Resident Aliens are eligible to apply for NPIs, but they must enroll using their IRS Individual Taxpayer Identification Number (ITIN) along with a photocopy of U.S. driver’s license, State issued ID, birth certificate or passport. See the NPPES Application form for more details.
Additional questions regarding applying for the NPI should be directed to the NPPES 1-800-465-3203 or customerservice@npienumerator.com.
Where can I get more information?
For more information about NPI enrollment, email: provider.enrollment@hca.wa.gov or call 1- 800-562-3022 (extension 16137). You may also visit: www.hca.wa.gov/enroll-as-a-provider
For questions or comments about the IMC SERI please email Gail Kreiger: gail.kreiger@hca.wa.gov