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15 <br /> Attachment B: Getting Set Up with the Financial Executor Portal <br /> The Washington Health Care Authority has contracted with Public Consulting Group (PCG) to serve <br /> as the statewide financial executor for the Medicaid Transformation Project. PCG has created a <br /> web-portal for partner organizations where payments will be issued from. <br /> While the North Sound ACH does.not manage.this.-portal.,.we.can help get theprocess started by <br /> doing the initial registration of your organization. Subsequent steps will occur by email between <br /> your organization and the Financial Executor. <br /> To ensure that the email is sent to the correct person,we need the information requested below. <br /> We will use this information to set up your initial account in PCG's Financial Executor web portal. <br /> Once the initial account is set up with PCG, which includes a process of verifying your tax ID <br /> number with the IRS,your designated point of contact will receive an email to complete your <br /> organization's registration in the portal. To complete the registration process,you will need to <br /> provide: <br /> ▪ Bank account information, if your organization wishes to receive payments by direct deposit. <br /> • Payee information and address, if your organization wishes to receive payments by physical <br /> check. <br /> If you are registered with the portal through work with another Accountable Community of Health <br /> (ACH), you will not be asked to r'egitter'fihiice or have Multiple accounts; PCG will track payments <br /> issued under different ACH projects.To get started, please identify: <br /> City of Everett <br /> 1) Public, private or tribal organization name: <br /> CRITICAL:Please enter official business name as recognized by the Internal Revenue Service. <br /> 2) Employer Identification Number: 91-600-1248 <br /> You may know this as your EIN,TIN or FEIN. <br /> 3) Point of Contact: (this person must be someone who has the authority to respond to "click" <br /> agreements on the Financial Executor portal) <br /> First Name: <br /> Hil Last Name: Kaman <br /> hkaman@evereftwa.gov 425-257-8762 <br /> Email Address: Phone Number: <br /> If you have questions, please contact Hillary Thomsen, at(360) 543-8858. <br /> You may return this form by: <br /> 1) Attachment to an email to Hillary@NorthSoundACH.org; <br /> 2) FAX(360-933-3653); or <br /> 3) Via physical mail to: <br /> North Sound ACH <br /> PO Box 4256 <br /> Bellingham, WA 98227 <br /> North Sound ACH May 2018 Call for Partners:Attachment B 1 <br /> 133 <br />