Medicaid billing records (WA)
Tracking # |
PDR 2018-027 |
Submitted | Jan. 20, 2018 |
Est. Completion | March 27, 2018 |
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Communications
From: Evan Anderson
To Whom It May Concern:
Pursuant to RCW Ch. 42.56 (Public Records Act), I hereby request the following records:
A spreadsheet of Medicaid billing records from 1/1/2000 through 2017. Specifically, I am interested in information related to the service provided (for example, psychotherapy), the primary diagnosis related to the service provided, and the amount reimbursed, for the following NPIs:
1346359163
1417097379
The requested documents will be made available to the general public, and this request is not being made for commercial purposes.
In the event that there are fees, I would be grateful if you would inform me of the total charges in advance of fulfilling my request. I would prefer the request filled electronically, by e-mail attachment if available or CD-ROM if not.
Thank you in advance for your anticipated cooperation in this matter. I look forward to receiving your response to this request within 5 business days, as the statute requires.
Sincerely,
Evan Anderson
From: Health Care Authority
Good Afternoon Mr. Anderson,
Please see the attached acknowledgment letter in response to your public disclosure request, PDR 2018-027.
Sincerely,
Tina
Tina Leipski
Public Disclosure Specialist
Division of Legal Services
office: 360-725-1911
tina.leipski@hca.wa.gov<mailto:tina.leipski@hca.wa.gov>
[cid:image001.png@01D396B0.EC799D80]<http://www.hca.wa.gov/>
[cid:image028.png@01D1C583.2CBF7EB0]<http://www.facebook.com/WAHealthCareAuthority>
[cid:image029.png@01D1C583.2CBF7EB0]<http://www.twitter.com/WA_Health_Care>
[cid:image030.png@01D1C583.2CBF7EB0]<http://www.hca.wa.gov/hcaconnect/default.aspx>
[cid:image031.png@01D1C583.2CBF7EB0]<http://www.youtube.com/channel/UC2_tBogIUnVye4GBwbVXxNw>
From: Health Care Authority
Mr. Anderson,
Staff have replied with the following:
"Please let the requestor know that we made a transition to a large data system, ProviderOne, in mid 2010. Data that was migrated and available prior to that date did not go through as many quality checks as claims do in ProviderOne after mid 2010. Would the requestor be amenable to pulling data for NPIs 1346359163 and 1417097379 from July 2010 going forward instead? Also I am hearing that the requestor would like us to provide the following data elements within the file. Please have them confirm we aren't missing anything:
NPI (We will look for the NPI whether it is the servicing provider or the billing provider)
Provider Name
Primary Diagnosis code
Primary Diagnosis Name
Service date (may only be able to provide the year due to HIPAA restrictions)
Count of paid/accepted claims
Sum of the amount paid to the provider
Please have the requestor confirm that we aren't missing anything from this data element list and respond regarding our recommendations."
Please let me know how you would like us to proceed.
Sincerely,
Tina
Tina Leipski
Public Disclosure Specialist
Division of Legal Services
office: 360-725-1911
tina.leipski@hca.wa.gov<mailto:tina.leipski@hca.wa.gov>
[cid:image001.png@01D3999E.CB765A10]<http://www.hca.wa.gov/>
[cid:image028.png@01D1C583.2CBF7EB0]<http://www.facebook.com/WAHealthCareAuthority>
[cid:image029.png@01D1C583.2CBF7EB0]<http://www.twitter.com/WA_Health_Care>
[cid:image030.png@01D1C583.2CBF7EB0]<http://www.hca.wa.gov/hcaconnect/default.aspx>
[cid:image031.png@01D1C583.2CBF7EB0]<http://www.youtube.com/channel/UC2_tBogIUnVye4GBwbVXxNw>
From: Evan Anderson
Hi there,
Thanks for the email. Yes, those are the correct data elements. Also, data from July 2010 through 2017 sounds good to me. If any more questions come up don't hesitate to reach out.
Sincerely,
Evan
From: Evan Anderson
Hello,
Looking to see if there's an update on this request.
Best,
Evan
From: Health Care Authority
Good Morning,
I have not received any updates from staff so I believe we are still on track for March 27, 2018.
Sincerely,
~Tina
Tina Leipski
Public Disclosure Specialist
Division of Legal Services
office: 360-725-1911
tina.leipski@hca.wa.gov<mailto:tina.leipski@hca.wa.gov>
[cid:image001.png@01D39FF6.9FCBEF70]<http://www.hca.wa.gov/>
[cid:image028.png@01D1C583.2CBF7EB0]<http://www.facebook.com/WAHealthCareAuthority>
[cid:image029.png@01D1C583.2CBF7EB0]<http://www.twitter.com/WA_Health_Care>
[cid:image030.png@01D1C583.2CBF7EB0]<http://www.hca.wa.gov/hcaconnect/default.aspx>
[cid:image031.png@01D1C583.2CBF7EB0]<http://www.youtube.com/channel/UC2_tBogIUnVye4GBwbVXxNw>
From: Health Care Authority
Good Afternoon Evan,
Staff began working on your request and noticed that they don't have those two NPI's as providers with an active status in ProviderOne. Is there a name they can search or another NPI for the providers?
Please advise. Thank you!
Sincerely,
~Tina
Tina Leipski
Public Disclosure Specialist
Division of Legal Services
office: 360-725-1911
tina.leipski@hca.wa.gov<mailto:tina.leipski@hca.wa.gov>
[cid:image001.png@01D3A730.DD0E5850]<http://www.hca.wa.gov/>
[cid:image028.png@01D1C583.2CBF7EB0]<http://www.facebook.com/WAHealthCareAuthority>
[cid:image029.png@01D1C583.2CBF7EB0]<http://www.twitter.com/WA_Health_Care>
[cid:image030.png@01D1C583.2CBF7EB0]<http://www.hca.wa.gov/hcaconnect/default.aspx>
[cid:image031.png@01D1C583.2CBF7EB0]<http://www.youtube.com/channel/UC2_tBogIUnVye4GBwbVXxNw>
From: Evan Anderson
Hi there,
The two NPIs correspond to a Dr. Laura Susan Brown and a Dr. Sandra Lee Paulsen.
Hope that helps!
Evan
From: Health Care Authority
Good Morning Mr. Anderson,
Please see the attached closure letter in response to your public disclosure request, PDR 2018-027.
Sincerely,
~Tina
Tina Leipski
Public Disclosure Specialist
Division of Legal Services
office: 360-725-1911
tina.leipski@hca.wa.gov<mailto:tina.leipski@hca.wa.gov>
[cid:image001.png@01D3AAEA.92DB2160]<http://www.hca.wa.gov/>
[cid:image028.png@01D1C583.2CBF7EB0]<http://www.facebook.com/WAHealthCareAuthority>
[cid:image029.png@01D1C583.2CBF7EB0]<http://www.twitter.com/WA_Health_Care>
[cid:image030.png@01D1C583.2CBF7EB0]<http://www.hca.wa.gov/hcaconnect/default.aspx>
[cid:image031.png@01D1C583.2CBF7EB0]<http://www.youtube.com/channel/UC2_tBogIUnVye4GBwbVXxNw>