Social Service .dat Batch Upload
Setup Guide
ProviderOne
April 2023
Version .07
Page 2 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
Revision History
Date
Version
Description
Author
11/2014
.01
Initial draft
Karla Wooster
12/2014
.02
Added new rejection code 92064
Karla Wooster
3/2015
.03
Updated introduction
Karla Wooster
3/2015
.03
Updated contacts for provider support
Karla Wooster
3/2015
.03
Added basic billing training links
Karla Wooster
3/2015
.03
Added batch upload screen shots
Karla Wooster
3/2015
.03
Added causes for error code reference table
Karla Wooster
3/2015
.03
Added ProviderOne log on screen hyperlink
Karla Wooster
3/2015
.03
Added new alert message search tip
Karla Wooster
3/2015
.03
Corrected payment cycle information
Karla Wooster
3/2019
.04
Updated batch upload format to include EVV fields
Karla Wooster
3/2019
.04
Updated ProviderOne contacts/Remove BASS
Karla Wooster
9/2020
.05
Updated 2.1.3.1 Social Service .dat Batch Upload
Format Specification Table
Dustin Quinn Campbell
9/2020
.05
Updated 3.1.1.1 Sample of Social Service Batch
Upload .xls before Caret Delimiter (.dat)
Conversion
Dustin Quinn Campbell
9/2020
.05
Updated 3.1.1.2 Caret delimiter (.dat) Format
Sample
Dustin Quinn Campbell
10/2020
.06
Corrected table 3.1.1.1
Dustin Quinn Campbell
10/2020
.06
Corrected .dat string examples in 3.1.1.2
Dustin Quinn Campbell
4/2023
.07
Updated
Jacquelyn Pinkerton
Page 3 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
Table of Contents
Contents
Revision History .................................................................................................................................. 2
Table of Contents ................................................................................................................................ 3
1. Social Service Batch Upload Billing .............................................................................................. 4
1.1 Document Purpose ...................................................................................................................................................... 4
1.2 Intended Users ............................................................................................................................................................. 5
1.3 Relationship to the Social Service Billing Guides .................................................................................................... 5
1.4 Roles and Responsibilities ......................................................................................................................................... 5
2. System Preparation ......................................................................................................................... 6
2.1.1 Social Service Provider Characteristics .................................................................................................................. 6
2.1.2 Special Design Constraints or Considerations ....................................................................................................... 6
2.1.3 Business Rules ....................................................................................................................................................... 7
3. Social Service Batch Upload File Creation .................................................................................. 12
3.2 Caret delimiter (.dat) File Naming Convention ....................................................................................................... 14
3.3 File extension .xls convert to .dat ............................................................................................................................ 15
3.3.1 METHOD ONE: Changing your computer’s default ‘list separator’ to a tilde ....................................................... 15
Create .dat file from EXCEL to CSV (MS-DOS) to Save As ........................................................................................ 15
3.3.2 METHOD TWO Create .dat file from EXCEL to WORD to Save As .................................................................... 17
4. Submitting the social service batch upload caret delimiter (.dat) file ....................................... 20
5. Provider Support ........................................................................................................................... 32
6. Frequently Asked Questions ........................................................................................................ 33
Page 4 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
1. Social Service Batch Upload Billing
Social service .dat batch upload billing is an optional billing method to allow providers to extract
billing data elements from their current timekeeping and/or billing software and upload the claim(s)
data into the ProviderOne system. Although .dat batch upload does require additional preparation,
your agency could save time and effort with this option. If you are interested in using this method,
work with your timekeeping or billing vendor. Many software vendors currently bill in ProviderOne
and are setup and ready for billing. They understand the technical complexities of extracting data
from their software systems to meet ProviderOne requirements. This billing option should not be
confused with template batch billing. Template batch billing is suited for providers who bill with daily
and/or monthly unit types and serve smaller client populations.
The .dat batch upload billing method is suitable for large providers and/or providers who are required
to bill by date of service such as home care agencies, adult day care centers, large residential
facilities, home delivered meals programs, and personal emergency response systems.
ProviderOne is designed to increase the accuracy and flexibility of billing. Social service .dat batch
upload billing is one of three billing methods available in ProviderOne.
1. Direct Data Entry (DDE) billing
2. Template billing and Template batch billing (optional)
3. Caret delimiter (.dat) Social Service batch upload billing (optional)
You can use the caret delimiter (.dat.) batch upload method with standard personal computing
software, such as Excel. However, this method requires an intermediate level of understanding of
Microsoft Excel, formatting custom cells, Microsoft Word, Notepad, and how to save and open files
using different file formats. If you have difficulty preparing for the social service .dat batch upload
method, you may want to consult a computer specialist or another software vendor.
1.1 Document Purpose
This guide will explain the social service batch upload billing method and provide instructions on
submitting and managing batch upload claims.
• Identify provider types likely to benefit using the batch upload billing method.
• Facilitate format requirements of the caret delimiter (.dat) file uploaded into
ProviderOne.
• Communicate the data requirements and business rules for caret delimiter (.dat) file
submission.
• Provide the framework for understanding and interpreting:
o Batch upload file creation
o Naming the caret delimiter (.dat) file
o Submitting the caret delimiter (.dat)
o Monitoring the social service batch upload status screen
o Analyzing error codes
Page 5 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
1.2 Intended Users
This setup guide is designed for providers’ technical and/or billing staff, timekeeping and/or
software vendors responsible for adapting/altering software systems to extract data to create
files to be upload into ProviderOne.
Please note: Social service medical claims cannot be submitted using the social service .dat
batch upload method. Social service medical claims must bill as medical providers and use the
billing screens in the medical billing section of the provider portal. There is a batch upload
billing method for social service medical providers called HIPAA batch upload. This method
requires HIPAA batch testing. Interested providers can contact the Health Care Authority
(HCA) three to four months in advance to prepare for medical HIPAA batch upload billing. For
additional information visit the HCA website at https://www.hca.wa.gov/billers-providers-
partners/prior-authorization-claims-and-billing/hipaa-electronic-data-interchange-edi and select
one of the ProviderOne 5010 Companion Guides. For additional questions call 1-800-562-3022
(choose “provider services”) or email hipaa-he[email protected]ov and have your NPI available.
1.3 Relationship to the Social Service Billing Guides
The Social Service .dat Batch Upload Setup Guide will assist providers and/or technical staff
setting up software systems and files to meet specific requirements of ProviderOne social
services .dat batch upload billing. It is intended to supplement the social service billing guides
and/or social service billing trainings. It contains rules for format, content, and field values for
social service .dat batch upload billing.
1.4 Roles and Responsibilities
When you choose to use the social service .dat batch upload billing method, it is highly
recommended that you consult and/or collaborate with your current billing/time keeping vendor
and/or a computer specialist. Mastering this billing method requires attention to detail as well as
the ability to follow complex instructions. There is no standard ‘how to guide’ for this method
because adding, updating, and extracting the data elements are unique to each billing system
used by providers.
Providers, billing staff, and/or technical staff, timekeeping and/or software vendors:
• Add the necessary data elements into their timekeeping and/or billing software.
• Know and understand the contents of this guide as well as the social service
supplemental billing guides: Authorizations, Basic Billing, Claims Status Inquiry & View
RA, and Adjust, Void, & Resubmit Claim. https://www.hca.wa.gov/billers-providers-
partners/providerone/providerone-social-services
• Create the caret delimiter (.dat) file and upload the caret delimiter (.dat) file into the
ProviderOne system.
• Manage multiple caret delimiter (.dat) file submissions.
• Analyze error codes, correct errors, and resubmit files for billing.
NOTE: When the file is uploaded to the system, a confirmation message is immediately
displayed. In less than 5 minutes or as long as 24 hours a status message will appear in
the social service batch upload status page. An acceptance message means the file has
been accepted and submitted for claims processing/adjudication. A rejection message
Page 6 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
means the file was not accepted and NO DATA in the caret delimiter (.dat) file is
considered for claims processing/adjudication until the errors are corrected and/or
removed and the file is accepted after resubmission.
ProviderOne Health Care Authority:
Provide assistance with understanding the necessary data elements, caret delimiter (.dat)
file submissions steps, and caret delimiter (.dat) files rejection messages. Providers can
contact ProviderOne Health Care Authority by email.
ProviderOne Health Care Authority Email
hipaa-hel[email protected]a.gov.
• Type in the subject line: Social Service Batch Upload <insert domain #>
• In the body of the email include the name of the batch file you are referencing:
*sample: SOC.xxxxxxx.20150131xxxxxx.SAMPLE_BATCH.dat. and/or other
pertinent information. Include your telephone number if you request a return call.
(*Sample contains ‘x’ for numbers to mask provider identification)
2. System Preparation
Below are the ProviderOne transaction standards and business rules for social service .dat
batch upload billing. Please share the technical information with your time keeping and/or
billing staff/vendor.
2.1.1 Social Service Provider Characteristics
• Home Care Agencies;
• Consumer Directed Employers;
• Personal Emergency Response Systems; or,
• Other social service providers with significant claim volume and/or must bill by date
of service (assisted living, supported living, home delivered meals, adult day care,
etc.).
2.1.2 Special Design Constraints or Considerations
• The size of each file is limited to 50MB.
• The system will only accept files with ‘.dat’ extension for batch submission.
• All claim lines of the batch file must not exceed one day of service; with the exception
of monthly unit types such as personal emergency response systems.
(Note: Daily rates cannot span bill using batch upload method. Span billing is only used in the
direct data entry and templates methods with daily or monthly unit types).
• The system will only accept one claim line per each day of service, service
code, servicing provider (if applicable), and authorization number combination.
The system will deny duplicate claim lines.
• The batch file layout and format must comply with the specifications outlined in Table
2.1.3.1.
Page 7 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
• Unit types must be consistent with the authorization list page. Most billing hours
are reported in 15 minute increments (15 min = 1 unit).
• Each field in the batch file must be separated/delimited by a ‘^’ (caret symbol),
including when the following fields are left empty: Patient Account Number; SS
Servicing Only ProviderOne ID; Service Start Time; Service End Time; Service Start
Time Geo-Data; Service End Time Geo-Data; Client-Provider Proximity for Start
Time; Client-Provider Proximity for End Time; and, Client Verification for End Time.
Do not add spaces between the carets ^.
• The end of every field line must also be represented/indicated by a ‘~’ (tilde)
including the last line of the batch.
• Claim header (Provider ID, Client ID and Authorization Number) must be repeated for
every line in batch file besides the other required fields.
• The following fields require a placeholder even if the fields are not populated with
data: Modifier 1; Modifier 2; Modifier 3; Modifier 4; Patient Account Number; SS
Servicing Only ProviderOne ID; Service Start Time; Service End Time; Service Start
Time Geo-Data; Service End Time Geo-Data; Client-Provider Proximity for Start
Time; Client-Provider Proximity for End Time; and, Client Verification for End Time,
Parent TCN, Policy Number (1), Payer/Organization Name (1), Amount (1),
Adjustment Reason Code (1), Policy Number (2), Payer/Organization Name (2),
Amount (2), Adjustment Reason Code (2), Manual Claims indicator. Do not add
spaces between the carets ^.
Note: The following fields are for Electronic Visit Verification (EVV) data. EVV
requirements apply only to Home Care Agencies and Consumer Directed Employers.
EVV data is not required for claims submitted prior to 01/01/2020. The EVV-related
data fields are: SS Servicing Only ProviderOne ID; Service Start Time; Service End
Time; Service Start Time Geo-Data; Service End Time Geo-Data; Client-Provider
Proximity for Start Time; Client-Provider Proximity for End Time; Client Verification for
End Time, and Manual Claims Indicator.
2.1.3 Business Rules
• A provider can upload only one file at a time.
• The size of each file is limited to 50 MB.
• Not all fields are required. Data is not required for optional fields.
• The provider must have data for all the required fields.
• The file will be transmitted over secure HTTP using encryption.
• Providers can view only their own transactions.
• Only ‘.dat’ extension file types are accepted by the system. If provider attempts to upload a file whose
extension is not ‘.dat’ the system will display an error message.
• When a batch is successfully uploaded, the system will generate the file name while displaying the
confirmation message. Standard for file name for the generated message is “<SOC>.<Provider ID (7
digit)>.<Date & Time Stamp>.<Actual file name including ‘.dat’ extension>”. *sample:
“SOC.xxxxxxx.20130131xxxxxx.SAMPLE_BATCH.dat”
(*Sample contains ‘x’ for numbers to mask provider identification)
• When an uploaded .dat batch file contains no validation errors, the batch file status will be
Page 8 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
‘Accepted’ and claims will be loaded into the system for processing.
• When a batch file has encountered errors during file validation then the status of the file will be
'Rejected'. No claims will be loaded into the system.
2.1.3.1 Social Service .dat Batch Upload Format Specification Table
Required Field (Y /
N)
Data Type
Maximum Size
String Format
Development Notes
Provider ID
Y
string-9
9 digits
numeric
9 digit Provider ID
Client ID
Y
string – up to
20
20 characters
alphanumeric
Client ID
Authorization Number
Y
string – 10
10 digits
Numeric
Authorization Number
Service Date From
Y
string – 8
8 digits
Date (mmddccyy)
Service Date From
Service Date To
Y
string – 8
8 digits
Date(mmddccyy)
Service Date To
Service code
Y
string – 5
5 digits
alphanumeric
Service code
Modifier 1
N (place holder required)
string – 2
2 digits
alphanumeric
Modifier 1
Modifier 2
N (place holder required)
string – 2
2 digits
alphanumeric
Modifier 2
Modifier 3
N (place holder required)
string – 2
2 digits
alphanumeric
Modifier 3
Modifier 4
N (place holder required)
string – 2
2 digits
alphanumeric
Modifier 4
Units
Y
string – up to
16
16 digits
numeric
Units
(use whole numbers/not decimals)
Patient Account
Number
N (place holder required)
string – up to
13
13 digits
alphanumeric
“Optional” Patient
Account Number
SS Servicing Only
ProviderOne ID
N (place holder required)
string-9
9 digits
numeric
SS Servicing Only ProviderOne ID
Service Start Time
N (place holder required)
string-6
6 digits
numeric
Service Start Time
Service End Time
N (place holder required)
string-6
6 digits
numeric
Service End Time
Service Start Time Geo-
Data Latitude
N (place holder required)
string-9
6 or 7 digits with
Sign and a
decimal
numeric
Service Start Time Geo-Data – Latitude
This will contain Sign. EX: “-12.99999”
The system accepts either 4 or 5 digits after
decimal
Service Start Time Geo-
Data Longitude
N (place holder required)
string-10
7 or 8 digits with
Sign and a
decimal
numeric
Service Start Time Geo-Data – Longitude
This will contain Sign. EX: “-12.99999”
The system accepts either 4 or 5 digits after
decimal
Service End Time Geo-
Data Latitude
N (place holder required)
string-9
6 or 7 digits with
Sign and a
decimal
numeric
Service End Time Geo-Data – Latitude
This will contain Sign. EX: “-12.99999”
The system accepts either 4 or 5 digits after
decimal
Page 10 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
Required Field (Y /
N)
Data Type
Maximum Size
String Format
Development Notes
Service End Time Geo-
Data Longitude
N (place holder required)
string-10
7 or 8 digits with
Sign and a
decimal
numeric
Service End Time Geo-Data – Longitude
This will contain Sign. EX: “-12.99999”
The system accepts either 5 or 6 digits after
decimal
Client-Provider Proximity
for Start Time
N (place holder required)
string – 1
1 Character
alphanumeric
Client-Provider Proximity for Start Time
Client-Provider Proximity
for End Time
N (place holder required)
string – 1
1 Character
alphanumeric
Client-Provider Proximity for End Time
Client Verification for End
Time
N (place holder required)
string – 1
1 Character
alphanumeric
Client Verification for End Time
Claim Frequency Type
Y
string – 1
1 digit
numeric
Values can be:
1 = Original Claim
7 = Adjustment
8 = Void
Parent TCN
N (place holder required)
string – 18
18 digits
numeric
18-digit TCN#
Policy Number (1)
N
string – 15
15 digits
alphanumeric
Policy Number
This is 13 Characters in ProviderOne.
Payer / Organization
Name (1)
N
string – 50
50 digits
alphanumeric
Payer / Organization Name.
All CAPITAL LETTERS
Amount (1)
N
string – 17
13 digits with
Sign and two
decimals
Floating Number
TPL Amount by the the Payer/Org
Example:
1234567891234.00
-1234567891234.00
100.00
Adjustment Reason Code
(1)
N string – 3 3 digits alphanumeric Adjustment Reason Code.
Policy Number (2) N string – 15 15 digits alphanumeric Policy Number
This is 13 Characters in ProviderOne.
Payer / Organization
Name (2)
N string – 50 50 digits alphanumeric Payer / Organization Name.
All CAPITAL LETTERS
Amount (2) N string – 17 13 digits with
Sign and two
decimals
Floating Number TPL Amount by the the Payer/Org
Example:
Page 11 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
Required Field (Y /
N)
Data Type
Maximum Size
String Format
Development Notes
1234567891234.00
-1234567891234.00
100.00
Adjustment Reason Code
(2)
N string – 3 3 digits alphanumeric Adjustment Reason Code.
Manual Claims Indicator N string – 6 6 Character alphanumeric Values can be:
SPST01
SPET01
SPEV01
EVSF01
CLSD01
Should be one of the above values available
for the Manual Claims Indicator Lookup Code
in ProviderOne otherwise error.
3. Social Service .dat Batch Upload File Creation
3.1.1.1 Sample of Social Service Batch Upload .xls before Caret Delimiter (.dat)
Conversion
Sample_SS_Batch_Up
load_before_Caret_De
(Sample contains ‘x’ for numbers to mask provider identification)
3.1.1.2 Caret delimiter (.dat) Format Sample
When creating or extracting the caret delimiter (.dat) file from your system take extra care
not to add extra spaces, characters, or extra carriage returns. Compare your caret delimiter
(.dat) file format content side by side to the examples below. They should be very similar
except the file will contain your provider and client specific ProviderOne numbers and
codes. The caret delimiter (.dat) file cannot contain column headers. (Samples contains ‘x’
for numbers to mask provider identification)
(Sample original claim with optional patient account number and without EVV data)
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01012014^01012014^T1019^^^^^8^xxxx^^^^^^^^^^^1^^^^^^^^^^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx ^01042014^01042014^T1019^^^^^10^xxxx^^^^^^^^^^^1^^^^^^^^^^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx ^01102014^01102014^T1019^^^^^15^xxxx^^^^^^^^^^^1^^^^^^^^^^~
(Sample original claim without optional patient account number and EVV data)
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01012014^01012014^T1019^^^^^8^^^^^^^^^^^^1^^^^^^^^^^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx ^01042014^01042014^T1019^^^^^10^^^^^^^^^^^^1^^^^^^^^^^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx ^01102014^01102014^T1019^^^^^15^^^^^^^^^^^^1^^^^^^^^^^~
(Sample with adjusted claim with optional patient account number and without EVV data)
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01012014^01012014^T1019^^^^^8^xxxx^^^^^^^^^7^551701000117107000^^^^^^^^
^^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx
^01042014^01042014^T1019^^^^^10^xxxx^^^^^^^^^7^551701000117107000^^^^^^^^^^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx
^01102014^01102014^T1019^^^^^15^xxxx^^^^^^^^^7^551701000117107000^^^^^^^^^^~
(Sample adjusted claim without optional patient account number and EVV data)
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01012014^01012014^T1019^^^^^8^^^^^^^^^^^^^^7^551701000117107000^^^^^^^^^
^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01042014^01042014^T1019^^^^^10^^^^^^^^^^^^^^^7^551701000117107000^^^^^^
^^^^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01102014^01102014^T1019^^^^^15^^^^^^^^^^^^^^^7^551701000117107000^^^^^^
^^^^~
(Sample with adjusted claim with optional patient account number and EVV data)
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01012020^01012020^T1019^^^^^8^xxxx^xxxxxxxxx^123412^114413^-12.99999^-
123.99999^-12.9999^-123.99999^^7^551701000117107000^^^^^^^^^^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx ^01042020^01042020^T1019^^^^^10^xxxx^ xxxxxxxxx^123412^114413^-
12.99999^-123.99999^-12.9999^-123.99999^^7^551701000117107000^^^^^^^^^^~
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx ^01102020^01102020^T1019^^^^^15^xxxx^ xxxxxxxxx^123412^114413^-
12.99999^-123.99999^-12.9999^-123.99999^^7^551701000117107000^^^^^^^^^^~
Page 14 of 33 Social Service Batch Upload User Guide-Version .07 – April 2023
3.2 Caret delimiter (.dat) File Naming Convention
Before converting your files to the caret delimiter (.dat) format it would be beneficial to
create a naming convention to suit your business needs. Use a unique name for each file.
• File caret delimiter (.dat) names cannot contain spaces.
• File names are alphanumeric and can only allow the following special characters: . -
_
• Batch file names cannot contain any of the following characters: \ / : * ? < >
• Batch file caret delimiter (.dat) names cannot exceed 50 characters including the
four characters: ‘.dat’
When a batch is successfully uploaded, the system will generate the file name while
displaying the confirmation message. The standard file name for the generated message is
“<SOC>.<Provider ID (7 digit)>.<Date & Time Stamp>.<Provider naming convention
including ‘.dat’ extension>”. Example:
“SOC.XXXXXXX.20130131XXXXXX.SAMPLE_BATCH.dat”
(Samples contains ‘x’ for numbers to mask provider identification)
When naming your caret delimiter (.dat) files you may want to consider the following:
• Number resubmissions of rejected files.
• Name the batch to identify the submitter.
• Name the batch to identify the location.
• Name the batch to identify the type of service provided.
Page 15 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
3.3 File extension .xls convert to .dat
When your billing or timekeeping vendor only allows .xls extraction and not .dat file extraction
there are directions below on how to convert the Excel (.xls) file to a ‘Data File’ (.dat). If you
do not want to use either method listed you can find and/or purchase utility programs online
for Excel that will easily convert files into the .dat format. For the best results, try using a
Google search and type “Excel utilities” or “.xls convert to .dat.”
Below are two methods converting .xls Excel document into the .dat format. Method one
shows how to change a computer’s default list separator settings. The second does not
require a change in the computers default settings.
3.3.1 METHOD ONE: Changing your computer’s default ‘list separator’ to a tilde
This method is recommended for large .dat files with over 1000 to 1500 plus
records.
Create .dat file from EXCEL
1. In Microsoft Windows, click inside the search icon and type ‘Control
Panel.’
2. Click the ‘Region’ icon.
3. Click ‘Additional Settings’
4. Find the ‘list separator’ drop down and type ^
5. Click ‘apply’ and OK twice.
Page 16 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
IMPORTANT NOTE
: After you change the list separator character for your computer, all
programs will use the new character as a list separator. You can change the character back
to the default character by following the same procedure.
Correctly Formatting Excel
1. Format your date cells to mmddyyyy by highlighting the date column
a) Right click and select ‘Format cells’
b) Select ‘Custom’ and place cursor in the ‘Type:’ field and type
mmddyyyy.
2. If you use the optional patient account number and do not populate
data in the optional EVV fields:
a) Right click into the last cell of the EVV and select ‘Format cells’
b) Select ‘Custom’ and place cursor in the ‘Type:’ field and type @~
c) Click OK
c)
Click OK
Page 17 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
3. If you do NOT add data in the optional account number and EVV
columns:
a) In the fields last line of the columns add a tilde ~
4. Delete the header row
5. Delete additional worksheets, including blanks
6. Click ‘Save As’
a) Locate the folder you would like to save your .dat file
b) In the ‘File Name:’ type the name and .dat
c) In the ‘Save As Type’ drop down, select CSV (Comma delimited) click
save.
d) The .dat may disappear and you will need to type it again.
NOTE BELOW: If you receive the message below that states file may contain features
that are not compatible with CSV (Comma delimited) ‘Do you want to want to keep the
workbook in this format?’, click “Yes”.
FOLLOW-UP NOTE (1): If the icon for notepad does not appear before the file name saved
to your computer, right click, select ‘Open with’ and choose ‘default program.’ Select ‘Notepad’
and make sure the box is checked for ‘Always use the selected program to open this kind of file’
and click OK. If this last step is not completed an unexplained rejection will occur in the
ProviderOne system.
FOLLOW-UP NOTE (2): If the computer changes the saved file extension and adds
.csv to the .dat extension file name, go back to your saved document. Do not open the
document. Highlight the document, right click and remove .csv from the name, and type
.dat. If that does not solve the issue, consider using different method of conversion. Try
using an excel utility to convert your files to the .dat extension.
3.3.2 METHOD TWO Create .dat file from EXCEL to WORD to Save As
(This method does not usually work on large files with more than 1500 records)
Correctly Formatting Excel
1. Format your date cells to mmddyyyy by highlighting the date column
a) Right click and select ‘Format cells’
Page 18 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
b) Select ‘Custom’ and place cursor in the ‘Type:’ field and type
mmddyyyy.
c) Click OK
2. When you use the optional patient account number with the EVV
fields:
a) Right click and select ‘Format cells’
b) Select ‘Custom’ and place cursor in the ‘Type:’ field and type @~
c) Click OK
3. When you do NOT use the optional patient account number and EVV
fields:
a) In the last field column following the EVV field add a tilde ~
4. Delete the header row
5. Delete additional worksheets, including blanks
6. Copy the entire worksheet (Ctrl A) and copy (Ctrl C)
Page 19 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
Using WORD to convert file to .dat
1. Open a new blank WORD document
2. Paste the copied file into WORD (Ctrl V). Do not worry if the contents here
do not fit onto the document margins.
3. Select the table by clicking the box at the left hand top corner.
4. Click on ribbon select the Layout Tab
5. On the ribbon select the box ‘Convert to Text’
6. You will be prompted to select ‘separate text with’
a) Select ‘Other’ and insert the caret symbol ^ and click okay
b) Copy the entire document (Ctrl A) and copy (Ctrl C)
NOTEPAD
1. Open Notepad (located in All Programs/Accessories file)
2. Click Ctrl V to paste data into document
3. Return to the File menu and select ‘Save As:’
a) Locate the folder you would like to save your caret delimiter (.dat) file
b) In the ‘File Name:’ type the name and .dat (file naming convention
link)
Page 20 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
c) In the ‘Save As’ section click the drop down and select ‘Text
Document’ (*.txt) and click Save
FOLLOW-UP NOTE (1): If the icon for notepad does not appear before the file name is saved
to your computer, right click, select ‘Open with’ and choose ‘default program.’ Select ‘Notepad’
and make sure the box is checked for ‘Always use the selected program to open this kind of file’
and click OK. If this last step is not completed an unexplained rejection will occur in the
ProviderOne system.
FOLLOW-UP NOTE (2): If the computer changes the saved file extension and adds .txt to the .dat
extension file name, go back to your saved document. Do not open the document. Highlight the
document, right click and remove .txt from the name, and type .dat. If that does not solve the issue,
consider using different method of conversion. Try using an excel utility to convert your files to the .dat
extension .
4. Submitting the social service batch upload caret delimiter (.dat) file
After the .dat file is created and saved to your computer system, you are ready to upload the
file into ProviderOne for claims submission. To enter the ProviderOne portal click:
https://www.waproviderone.org and enter your login information.
Step 1: On the Provider Portal click Social Service Batch Upload
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Step 2: Click Choose File
Step 3: Select the saved .dat file located on your computer and select OK to upload.
Page 22 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
Step 4: A confirmation message is received after the initial system check verifies the .dat
file extension and file size meet the system requirements. Click close.
Step 5: To upload additional files Select Upload and repeat Step 2 of this section.
Page 23 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
4.1 Acceptance Message
The next step will validate format and content. An acceptance message on the Social Service
Batch Upload Status List page means the file passed format and content requirements. This
means all your claim lines have been submitted for claims processing.
Social Service Batch Upload Status List Screen Shot.
4.2 Rejection Messages
The social service batch upload file will be rejected if the file does not meet the social service
batch upload standards and data structure previously outlined. You can extract a custom .xls
Page 24 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
report from the 4.2.2 Social Service Batch Upload Error Instance List that is user friendly and
explains the record reference and the error code that caused the file to reject.
Sometimes the system will give one rejection reason for each submission. You may correct or
remove the rejected lines and resubmit and find a new rejection message will appear.
You must remove the rejected lines and resubmit or correct the rejected lines and
resubmit. IMPORTANT: If one line on the batch rejects, no claim lines are submitted
for adjudication and payment.
It is highly recommended providers remove the rejected lines and resubmit the caret delimiter
(.dat) file to receive an accepted message for lines that do not contain errors to receive timely
payment. Rejected lines require further research. They are often the result of authorization
errors and authorization cancelations that can only be corrected by the case worker. The
case worker may not be available or able to immediately correct authorization errors.
4.2.1 Finding the record reference in error
After your batch has been rejected, it will be necessary to find the record reference in the
.dat file to either remove the record or correct the record.
You can find the record one of two methods.
4.2.1.1 Method One:
a. Open the caret delimiter (.dat) file that contains the errors.
b. Download the ‘Rejected’ messages.
c. Copy the ‘Additional Message’ in the rejection list.
d. Place your curser at the top of the first record in the caret delimiter (.dat) file
and click Ctrl F.
e. Paste that record reference line in the ‘Find what:’ box
f. Click ‘Find Next’ and the line will be highlighted in the caret delimiter (.dat) file
(see example below).
g. Remove the line or make corrections.
h. Save and rename the caret delimiter (.dat) file.
i. Upload the corrected .dat file into ProviderOne.
Page 25 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
4.2.1.2 Method Two:
a. See the instructions below 4.2.1 Converting the caret delimiter (.dat) file into
Excel file.
b. View the caret delimiter (.dat) file line number
c. The caret delimiter (.dat) file line number in excel will correspond to the
record reference error.
d. Remove the line or make corrections.
e. Save and rename the file to a caret delimiter (.dat) file.
f. Upload the corrected caret delimiter (.dat) file into ProviderOne.
4.2.1.2.1 .dat File converted to Excel screen shot
The example below demonstrates how to find the errors on a .dat file. The error message indicates
the field record count is not accurate. You can see that there is an extra caret symbol on lines 9
and 10.
Page 26 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
4.2.1 Converting the caret delimiter (.dat) file to an Excel file. Follow the instructions below:
1. Right click on the selected saved caret delimiter (.dat) file
2. Right click, or on the tabs above, click Open With: Excel
Page 27 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
IF EXCEL IS NOT LISTED
1. Right click, or on the tabs above, click Open With: Choose Default
Program
2. Select the browse button.
3. In the search program files type Excel.
4. After the EXCEL program appears double click the EXCEL program.
5. Excel appears.
6. Select Excel.
7. Unclick the box: ‘Always Use the Selected Program to Open This Kind of
File,’ if you do not want to change the default for WordPad. Click OK.
4.2.2 Social Service Batch Upload Error Instance List
Social Service Batch Upload Error Instance List will list the line number in the batch
(record reference number), the error code, the error message and an example of the caret
delimiter (.dat) batch line in the ‘Additional Message’ column. The Error code reference
table 4.2.2.1 contains the system error types you may receive.
Record
reference
▲ ▼
Error
Code
▼
Error Message ▲
▼
Additional Message ▲
▼
Record
Reference-
69
92141
Service Code and/or Modifier on the Claim do not
match those on the Social Service Authorization for
the Claims DOS
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01022014^01022014^T1019^^^^^12^
Record
Reference-
70
92141
Service code and/or Modifier on the Claim do not
match those on the Social Service Authorization for
the Claims DOS
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01102014^01102014^T1019^^^^^12^
Record
Reference-
71
92141
Service Code and/or Modifier on the Claim do not
match those on the Social Service Authorization for
the Claims DOS
xxxxxxxxx^xxxxxxxxxWA^xxxxxxxxxx^01132014^01132014^T1019^^^^^12^
4.2.2.1 Error Code Reference Table
The following table is the complete list of error code types when the social service batch upload
file is rejected. Common error codes and how to resolve them are found on Table 4.3.1.1
Common error codes. Analyzing challenging errors are located on Table
4.3.1.1 Common error
messages.
Error
Code
Error Message Possible Causes
90001
File content is empty
There is no data in the caret delimiter (.dat) file.
90002
File not present in physical location
The file being attached is not present.
90003
Record does not end with ~ symbol
The line is missing the ~ symbol at the end of the record.
90004
Field does not end with ^ symbol
There is no ^ symbol after the units and before the ~ symbol.
Page 28 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
Error
Code
Error Message Possible Causes
90005
Field count in the record is not equal to the actual
field count needed for that record
There are too few numbers in one of the date fields (example;
Provider Id, Client ID, Authorization #, etc.
91011 Provider ID not present in file
This message can occur for different reasons:
• The provider ID is missing from the line and/or file.
• Your provider record is in the process of being updated
and may not be payable for the next 24 hours.
91012
Provider ID must be numeric
The provider number contains letter(s).
91013
Provider ID length exceeds max allowed
characters
The provider number is too long.
91021
Client ID not present in file
The client ID is missing.
91022
Client ID must be alphanumeric
The client ID number contains symbols or other characters.
91023
Client ID length exceeds max allowed characters
The client ID is too long.
91031
Authorization Number not present in file
The authorization number is missing.
91032
Authorization Number must be numeric
The authorization number contains symbols or other characters.
91033
Authorization Number length exceeds max
allowed characters
The authorization number is too long.
91041
Service From Date not present in file
The service from date is missing.
91042
Service From Date is not a valid date
The service from date is not a date.
91043
Service From Date is a future date
The service from date is a future date
91051
Service To Date not present in file
The service to date is missing.
91052
Service To Date is not a valid date
The service to date is not a date.
91053
Service To Date is prior to Service From Date
The service to date is before the service from date.
91054
Service To Date is a future date
The service to date is a future date
91055
'Service Date From' and 'Service Date To' must
be within the same calendar month, please
update the dates of service and submit a
separate claim for each calendar month
The service from and service to date must occur in the same month.
91061
Service Code is not present in file
Service code is missing.
91062
Service Code must be alphanumeric
The service code contains symbols or other characters.
91063
Service code length exceeds max allowed
characters
The service code is too long.
91071
Modifier Code 1 must be alphanumeric
The modifier contains symbols or other characters.
91072
Modifier Code 1 length exceeds max allowed
characters
The modifier is too long.
91081
Modifier Code 2 must be alphanumeric
The modifier contains symbols or other characters.
91082
Modifier Code 2 length exceeds max allowed
characters
The modifier is too long.
91091
Modifier Code 3 must be alphanumeric
The modifier contains symbols or other characters.
91092
Modifier Code 3 length exceeds max allowed
characters
The modifier is too long.
91101
Modifier Code 4 must be alphanumeric
The modifier contains symbols or other characters.
91102
Modifier Code 4 length exceeds max allowed
characters
The modifier is too long.
91111
Units not present in file
The number of units are not in the file.
Page 29 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
Error
Code
Error Message Possible Causes
91112
Units must be numeric
The units contain symbols or other characters.
91113
Units length exceeds max value
The units are too long
91131
Patient Account Number must be alphanumeric
The patient account number contains symbols or other characters.
91132
Patient Account Number length exceeds max
allowed characters
The patient account number is too long.
92011
Provider ID does not exist in the system
The provider ID is not correct.
92012
Submitter Provider ID does not match with the
Provider ID in the batch file
The provider ID is not assigned to your domain.
92021
Client ID does not exist in system
The client ID number is not correct.
92031
Authorization Number does not exist in system
The authorization number is not correct.
92032
Provider ID mismatch in Authorization
The provider ID and authorization number are not authorized
together.
92033
Client ID in batch does not match P1
authorization
The client ID does not match the authorization number.
92061
Service Code does not exist in system
The service code is not correct.
92062
Medical Proc/Svc Code cannot be billed on a
Social Service Claim
Medical service codes cannot be billed in the social service billing
page.
92063
A separate claim line is required for each date
of service for the service/ service code entered
The unit type daily, hourly, each, and quarter hour must be billed by
date of service using the batch upload method.
Those unit types cannot be billed using span.
92064
The Proc/Svc Code Entered is designated for
automated payment generated only. This code
cannot be submitted or resubmitted for
payment.
This service cannot be billed. Payment is sent after the authorizing
worker end dates the authorization.
92071
Modifier Code 1 invalid
The modifier is not correct.
92081
Modifier Code 2 invalid
The modifier is not correct.
92091
Modifier Code 3 invalid
The modifier is not correct.
92101
Modifier Code 4 invalid
The modifier is not correct.
92140
Only one unit must be entered for a single day
You are billing more than one unit on a daily unit type.
92141
Service Code and/or Modifier on the Claim do
not match those on the Social Service
Authorization for the Claims DOS (date of
service)
This message can occur for different reasons:
1. The authorization is in Error for the DOS
2. The authorization has been canceled for the DOS
3. The DOS on the claim is outside the authorization DOS.
4. If none of the above notify ProviderOne Health Care
Authority at hipaa-he[email protected].
Type in the subject
line: Social Service Batch Upload <insert domain #>
In the body of the email include the name of the batch
file you are referencing: sample:
SOC.xxxxxxx.20150131xxxxxx.SAMPLE_BATCH.dat.
and other pertinent information. Include your telephone
number if you request a return call.
Page 30 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
4.3 Analyzing error codes
To analyze rejection error codes follow the steps listed below:
Step 1
Download the .xls Social Service Batch Upload Error Instance List
Step 2
View the ‘Error Message’ and ‘Additional Message’ column that displays the line that was
submitted. Compare the lines to the 3.1.1.2 Caret delimiter (.dat) format example.
Step 3
Compare the line error message to the line in the caret delimiter (.dat) file to find errors
and make corrections.
Step 4
If no formatting errors are found go to the authorization list page and conduct a filter by
search for the month you are submitting your claims. Note: You may need to add an
additional filter for processing status % in order to see authorization history.
a. Is the authorization in error for the DOS you are billing?
• If yes contact the authorizing case worker.
b. Has the authorization been canceled for the DOS you are billing?
• If yes contact the authorizing case worker
c. Are you billing for an authorization outside the DOS?
• If yes adjust your claim or contact the case worker to adjust the
authorization.
d. If you have checked all formatting errors, verified the authorization
information above, and cannot find the source of the error, contact;
ProviderOne Health Care Authority hipaa-hel[email protected]
Step 1: Type in the subject line:
Social Service Batch Upload <insert domain #>
Step 2: In the body of the email include the name of the batch file you are
referencing: sample:
SOC.xxxxxxx.20150131xxxxxx.SAMPLE_BATCH.dat. and any
other pertinent information.
Step 3: Include your telephone number if you request a return call.
4.3.1.1 Common Error Code Table
Many errors are common and some can be challenging to analyze. Below are several
examples identified by other social service .dat batch upload providers. To increase your
chances of a successful submission, pay special attention to NOT making the errors listed
below:
Problem Description
Error Code and Description
Solution
Service dates reported are not for the month
authorized.
92141 Service Code and/or
Modifier on the Claim do not
match those on the Social
Service Authorization for the
Claim DOS (date of service).
Ensure the service dates fall within the
month the service was authorized.
Page 31 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
Problem Description
Error Code and Description
Solution
The authorization is in error or canceled for
the dates of service submitted.
92141 Service Code and/or
Modifier on the Claim do not
match those on the Social
Service Authorization for the
Claim DOS (date of service).
Contact the case worker to resolve error or
explain why authorizations have been
canceled.
Service dates are for span billing and not
for the date the service was provided.
Daily rates, quarter hours, and each unit
types cannot use span billing. Span billing
is considered a date range. Only
monthly service codes such as
personal emergency response
systems can use span billing for social
service batch upload.
92063 A separate claim line is
required for each date of
service for the service/
service code entered.
Correct the dates and bill for services by
indicating the day the services were
provided. If you have questions about
billing for date of service, call the
specified social service batch upload
contact. Below is an example.
CORRECT:
From 12012013 To 12012013
From 12022013 To 12022013
ERROR:
From 12012013 To 12312013
Service dates are not formatted correctly.
91042 Service From Date is
not a valid date.
91052 Service To Date is not
a valid date.
Correct the date format to mmddyyy. If
you have questions call the specified
social service batch upload contact.
Below is an example.
CORRECT:
From 12012013 To 12012013
ERROR:
From 12/01/2013 To 12/01/2013
The file does not contain caret
placeholders for the four service code
modifiers even though there is no modifier
assigned to the service code in the
authorization list page.
90005 Field count in the
record is not equal to the
actual field count needed for
that record.
Add the placeholder caret symbol for the
service code modifiers. Do not add
spaces between the carets. Below is an
example of the service code and the
caret placeholders in between the
number of units.
CORRECT: T1019^^^^^10^
ERROR: T1019^10^
The caret delimiter (.dat) file contains a
caret after the last EVV field when data is
entered.
90005 Field count in the
record is not equal to the
actual field count needed for
that record.
Remove the caret. Below is an example
of the units showing the caret placement
after the last EVV field when data is
entered.
There are too many or too few caret
delimiters in your data string.
90005 Field count in the
record is not equal to the
actual field count needed for
that record.
Count the total number of carets before
the ~ and verify there are 32.*
*Caret count required as of 4/29/2023
Page 32 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
Problem Description
Error Code and Description
Solution
File contains extra characters, spaces or
delimiters that do not follow the required
format. Do not use periods, commas, #
symbols, etc.
90004 Field does not end with
^ symbol.
90003 Record does not end
with ~ symbol.
Remove all extra characters and spaces
other than caret ^ and the tilde ~.
Units must be in whole numbers.
90005 Field count in the
record is not equal to the
actual field count needed for
that record.
Only use whole numbers to represent
the number of units and remove the
.0000 that is displayed in the crosswalk
file. Below is an example:
CORRECT: ^13^
ERROR: ^13.0000^
5. Provider Support
Below you will find how to contact the ProviderOne Health Care Authority for assistance. Please remember
that caseworkers answer authorization questions about authorization errors and authorization cancelations.
ProviderOne HCA cannot update or change authorizations.
ProviderOne Health Care Authority:
Provides assistance with understanding the necessary data elements, caret delimiter
(.dat) file submissions steps, and caret delimiter (.dat) files rejection messages. Providers
can contact ProviderOne Health Care Authority by email.
ProviderOne Health Care Authority
Email hipaa-help@hca.wa.gov.
• Type in the subject line: Social Service Batch Upload <insert domain #>
• In the body of the email include the name of the batch file you are referencing:
sample: SOC.xxxxxxx.20150131xxxxxx.SAMPLE_BATCH.dat. and other pertinent
information. Include your telephone number if you request a return call.
Click the link below for help understanding the social service ‘How To’ guides:
Authorizations, Basic Billing, Claims Status Inquiry & View RA, and Adjust, Void, &
Resubmit Claim. Provides assistance with Getting Started (logging in and setting up
security), Managing Provider Data (verifying your business information), Adding Users,
Navigating ProviderOne and Solving Login & Password Issues
https://www.hca.wa.gov/billers-providers-partners/providerone/providerone-social-services
Page 33 of 33 Social Service Batch Upload User Guide-Version .04 – March 2019
6. Frequently Asked Questions
What changes do I need to make in order to use batch upload? It depends, carefully read and
follow the specifications in Social Services Batch Upload Setup Guide. Consult with your
timekeeping and/or billing vendor about modifying your current software.
I already use batch upload and bill in ProviderOne today for Medical services, can I just
continue to bill the same way for social services? No. You cannot bill for social services in the
medical ProviderOne provider portal using direct data entry, templates, or the HIPAA batch upload
billing method.
How do I know if I need to bill using the social service batch upload method? Home care
agencies or adult day care providing care for more than 10 clients per month, and/or assisted living
facilities, Supported Living providers, personal emergency response providers, and home delivered
meal agencies who provide care to more than 30-60 clients per month, should consider weighing the
benefits and considerations of using batch upload verses direct data entry and/or template billing
methods. Providers are not required to use the social services batch upload billing method.
Can I submit files larger than 50MB? No. You must separate files.
Can I adjust claims using the batch upload method? No. Claims cannot be adjusted using the
batch upload billing method. See the supplemental billing guide for assistance. Add link