Apple Health
Administered by Washington State Health Care Authority (HCA) through ProviderOne.
Washington Revenue Cycle Management
Medical billing for Washington practices — Apple Health, Medicare, and commercial payers.
Washington's Medicaid billing runs through Washington State Health Care Authority (HCA), and every managed-care plan has its own rules. We bill Apple Health, Medicare, and Washington's commercial payers correctly the first time — and follow every denial through to resolution.
The Washington payer landscape
Managed-care plans
- Apple Health managed-care plans (Amerigroup, Community Health Plan of Washington, Coordinated Care, Molina, UnitedHealthcare Community Plan)
Dominant commercial payers
- Premera Blue Cross
- Regence BlueShield
- Kaiser Permanente Washington
Why Washington claims get denied
- Wrong Apple Health managed-care plan on file among the five active MCOs
- ProviderOne claim rejected for an NPI or taxonomy mismatch at time of submission
- Prior authorization missing for a service a specific Apple Health MCO requires but another doesn't
- Behavioral health integration claims routed to the wrong component of an Apple Health plan
- Eligibility lapsed and wasn't re-verified before a visit in a high-turnover Medicaid population
Washington behavioral health billing
Washington has moved most behavioral health services into fully integrated Apple Health managed-care plans, so we verify the specific plan's integrated behavioral health billing rules before submission rather than assuming a statewide standard applies.
Credentialing comes first
ProviderOne enrollment plus separate credentialing with each Apple Health managed-care plan you'll bill is the standard Washington sequence — see our Washington credentialing page for the full timeline.
See Washington Credentialing →Billing and books together
Your Washington claims and your bookkeeping are handled by the same team, so collections, denials, and adjustments always tie back to your financials without a reconciliation gap between separate vendors.
Clearinghouses and EHRs we work in
AvailityOffice AllyWaystarTebraAdvancedMDSimplePracticeKipuTheraNestAveaICANotesBestNotes
5–7% of collections · $950/mo minimum — the same in every state.
Free analysis
Free Washington Revenue Leakage Analysis
Send a recent AR aging report and denial summary. We'll show you denial patterns by Apple Health plan, days in AR, and the fixes we'd make first.
Send de-identified reports only — we sign a Business Associate Agreement before any PHI is exchanged.