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Welcome to Idaho Medicaid


Provider Handbook UpdatesUse SHIFT+ENTER to open the menu (new window).
Updates have been made to the Provider Handbook. You may find the link on the left navigation panel of this website. Changes are noted at the beginning of each document. The updated documents are:
  • Chiropractor
  • Provider Types and Specialties
  • Therapy Services - Occupational and Physical
DME Claims Pricing IncorrectlyUse SHIFT+ENTER to open the menu (new window).

Claims billed for Durable Medical Equipment (DME) services with the RR modifier, submitted between 7/1/2017 – 8/10/2017 were incorrectly priced at 100% of the Usual and  Customary Rates (UCR) instead of 10% UCR.  The RR modifier identifies items IDHW requires to be ‘rent to own’ over a ten-month period and pays 10% of the UCR per month.  Impacted services have been identified and the issues causing the incorrect pricing have been corrected. Affected claims and providers are currently being reviewed and reprocessing should begin within a couple of weeks.  Claims submitted after 8/10/2017 are pricing correctly.

Healthy Connections RostersUse SHIFT+ENTER to open the menu (new window).
The August Healthy Connections Rosters have been posted to your secure Trading Partner Account.
August MedicAide Newsletter Now OnlineUse SHIFT+ENTER to open the menu (new window).

The August edition of the MedicAide Newsletter is now available online. Please click here for the latest news and information affecting Idaho Medicaid providers. If you must receive the MedicAide by mail, please dial 1 (866) 686-4272 and select option 3.

What Can a Trading Partner Account Do for You?Use SHIFT+ENTER to open the menu (new window).

A Trading Partner Account (TPA) provides a fast, efficient way to:

  • Submit claims
  • View claims status, regardless of the method of submission (paper, electronic, etc.)
  • View payment information
  • Check eligibility and limitations
  • Access referral and prior authorization information

Two new functions—Secure Messaging and Billing Agency Association Invites—will be added when the TPA application is upgraded in Fall 2017.  In addition, a TPA will be required in order to submit new enrollments, perform maintenance, and access paper maintenance forms.  To learn more about these new features, and why all providers MUST have one when the application is upgraded, please see the August 2017 MedicAide newsletter.

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 Claims Processing Schedule

Financial Payment Processing Cycles  
by spadmin
 8/14/2017 4:11 PM
Claims Processing Cycle 
by sticknec
 11/9/2011 1:35 PM
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