WAC 296-20-01040. Health care provider network continuing requirements

To continue to provide care for workers and be paid for those services, a provider must: (1) Provide services without unlawful discrimination; (2) Provide services and bill according to federal and state laws and rules, department rules, policies, and billing instructions; (3) Maintain material compliance with minimum provider network standards, department credentialing and recredentialing standards, and department's evidence-based coverage decisions and treatment guidelines, policies; and must follow other national treatment guidelines appropriate for their patient; (4) Inform the department or an applicable delegated credentialing entity of any material changes to the provider's application or agreement within fourteen calendar days including, but not limited to, changes in: (a) Ownership or business name; (b) Address or telephone number; (c) Professionals practicing under the billing provider number; (d) Any informal or formal disciplinary order, decision, disciplinary action or other action(s), including any criminal action, in any state; (e) Provider clinical privileges; (f) Malpractice claims or professional liability coverage; (5) Retain a current professional state license, registration, certification and/or applicable business license for the service being provided, and update the department of all changes; (6) Comply with department recredentialing process; and (7) Comply with the instructions contained in a department action, including documentation of compliance and participation in mentoring, monitoring, or restrictions.