Common use of INVOICING/BILLING REQUIREMENTS Clause in Contracts

INVOICING/BILLING REQUIREMENTS. a. The Contractor shall submit an invoice to the Purchaser’s billing address or a designated email address for each Appointment with the associated, completed and signed Master Contract Sign Language Interpreter Request form. b. The Contractor shall submit claims for HCA Medicaid requests to ProviderOne. HCA will not accept emailed invoices. c. Each invoice or claim shall be submitted for payment no later than ninety (90) days from the date the service was provided. d. All billing documents must be accurate, legible, and complete. e. Contractor must submit their invoices in accordance to the stipulations outlined in the Payment Processing section below. Invoices must include: i. A formatted invoice OR completed State of Washington Invoice Voucher Form A 19-1A; ii. Contract Number; iii. Interpreter’s name; iv. Interpreter’s Hourly rate; v. Contractor’s Unique Invoice Number vi. Contractor’s Statewide Vendor Number; vii. The organizational/requesting entity’s name; viii. Date and time slot required for the Appointment. The time should be either the scheduled start time of the Appointment or the time the Sign Language Interpreter shows up after the scheduled start time, whichever is later, through either the scheduled or actual end time, whichever is later. ix. Any applicable Supplemental Fees.

INVOICING/BILLING REQUIREMENTS. a. The Contractor shall submit an invoice to the Purchaser’s billing address or a designated email address for each Appointment with the associated, completed and signed Master Contract Sign Language Interpreter Request form. b. The Contractor shall submit claims for HCA Medicaid requests to ProviderOne. HCA will not accept emailed invoices. c. Each invoice or claim shall be submitted for payment no later than ninety (90) days from the date the service was provided. d. All billing documents must be accurate, legible, and complete. e. Contractor must submit their invoices in accordance to the stipulations outlined in the Payment Processing section below. Invoices must include: i. A formatted invoice OR completed State of Washington Invoice Voucher Form A 19-1A; ii. Contract Number; iii. Interpreter’s name; iv. Interpreter’s Hourly rate; v. Contractor’s Unique Invoice Number vi. Contractor’s Statewide Vendor Number; vii. The organizational/requesting entity’s name; viii. Date and time slot required for the Appointment. The time should be either the scheduled start time of the Appointment or the time the Sign Language Interpreter shows up after the scheduled start time, whichever is later, through either the scheduled or actual end time, whichever is later. ix. Any applicable Supplemental Fees. f. Contractor must submit their HCA Medicaid claims into ProviderOne in accordance with the ProviderOne Billing and Resource Guide. Claims must be properly completed to be accepted by ProviderOne. All fields marked with an asterisks are required. Additional required documentation: i. Fully completed Master Contract Interpreter Request Form ii. Prior Authorization number