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PDFWAC 388-835-0885

What disputes between providers and DSHS can be resolved through the administrative review process?

A provider can use the administrative review process to contest:
(1) An "errors or omissions" reimbursement rate adjustment issued to the provider (see WAC 388-835-0845) or DSHS's refusal to adjust a rate the provider believes is incorrect due to errors or omissions. The provider must request an administrative review within thirty days of receiving notification that a rate has been adjusted or that DSHS refuses to adjust the rate.
(2) The way in which a DSHS rule, contract provision, or policy statement was applied when calculating the provider's prospective cost related reimbursement system's rate.
(3) An audit finding, other audit determination, a rate review or other settlement determination.
[Statutory Authority: RCW 71A.20.140. WSR 01-10-013, ยง 388-835-0885, filed 4/20/01, effective 5/21/01.]