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Gainwell Provider Survey

​Gainwell Technologies is excited to invite providers to respond to our Provider Satisfaction Survey starting in February. Our Provider Feedback Team will email providers who have had recent interactions with Gainwell Technologies for Idaho Medicaid. The email will include a short survey, which should take 5 minutes or less to complete, and you can simply return it back to us via email. Provider Satisfaction Survey results will be supplied to the State. Thank you in advance for your valuable time and insight. We are looking forward to hearing from you.

2/2/2023 11:04 AM2/2/2023 11:04 AM3/31/2023
February MedicAide Newsletter Now Online
​​The February edition of the MedicAide Newsletter is now available online. Please click here for the latest news and information affecting Idaho Medicaid providers.
2/1/2023 2:51 PM2/2/2023 11:03 AM2/15/2023
DRG Claims Reprocessing

​An analysis of claims that were submitted between 10/1/2022 and 1/20/2023 showed that roughly 65% of all DRG claims must be reprocessed for accuracy. Providers do not need to do anything. Impacted providers will receive direct email communication from their Provider Relations Consultant over the next several weeks outlining the timeline, impact and expected outcome of our reprocessing efforts. Thank you for the continued service you provide to Idaho Medicaid participants; we look forward to correcting these impacted claims and appreciate your patience. 

1/31/2023 8:28 AM1/31/2023 8:52 AM2/28/2023
Provider Enrollment Application or Maintenance Case with "Needs More Info" Status
If any items need to be corrected on your enrollment or maintenance case, a letter will be generated and emailed to the address on file outlining what actions must be taken in order for the enrollment or maintenance case to be processed and the application will be returned in a “Needs More Info (NMI)” status. All items outlined on the letter must be addressed before you resubmit the case and only the changes requested should be made during this case. 
All communications from the Gainwell Provider Enrollment department are sent via email to the email address on file; be sure to check your junk folder in situations when you’re expecting correspondence or a response from the enrollment department.
1/27/2023 9:02 AM1/27/2023 9:02 AM3/31/2023
Provider Request for Alternate Effective Date Form Reminder!
Gainwell Technologies and IDHW worked jointly in 2022 to enhance the alternate effective date process and reduce burdens on the provider community when needing to elect a backdate of up to 365 days prior to the current date during the enrollment process. Any applicable license, certification or other required credential must be valid on or before the requested date.

In extremely unique situations, with supporting documentation, an alternate effective date of more than 365 days prior to the current date may be requested utilizing the current version of the Provider Request for Alternate Effective Date form. A claim and chart notes that reflect the requested alternate effective date are required in addition to the form. When requesting an alternate effective date, Gainwell and IDHW will not review or process the request if the current form is not utilized, or the claim and chart notes are missing. A rejection letter will be delivered via email to the email address associated to the case with additional instruction and information.
1/27/2023 8:59 AM1/27/2023 8:59 AM3/31/2023
Attention Providers Licensed by the State of Idaho Bureau of Facility Standards

​If you are a provider who is licensed by the State of Idaho Bureau of Facility Standards and you’ve completed your renewal with them, Gainwell Technologies will update the license information on the provider record on your behalf and participation in the Idaho Medicaid program will continue.
Gainwell, in collaboration with IDHW, is working to establish a process for these license updates for future years and will communicate with the impacted providers once more information is available.
Thank you for the service and care you offer to our Idaho Medicaid participants.  

1/27/2023 8:56 AM1/27/2023 8:56 AM2/28/2023
2022 1099 Information for Providers

​Any provider who received payments totaling $600 or more for the calendar year of 2022 will receive a 1099 from Idaho Medicaid. All 1099s will be mailed by 1/31/2023 to the W9 address that is on file. Please review the FAQs in the 1099 category for more information related to the 1099. Contact us at 1(866) 686-4272 or contact your Regional Provider Relations Consultant with any unanswered questions you may have. Thank you! 

1/26/2023 5:21 PM1/26/2023 5:21 PM2/28/2023
Attention Home Health and PCS Providers – Claim Processing Timeframe

​All claims that are subject to Electronic Visit Verification (EVV) may pend for up to 10 days, in order to identify a correlating visit that was submitted through your aggregator, however 90% of these claims process within  three days. It’s best practice to submit claims earlier in the week to allow the necessary time for the visit search to be completed. Claims submitted on Thursday will not have enough time to pend, search for the visit and be picked up and included in the financial cycle by Thursday evening. Please note that all claims may pend for up to 30 days for reasons other than EVV, if manual review and intervention is necessary.  

1/23/2023 8:28 AM1/23/2023 8:28 AM3/31/2023
Extended Maintenance Window January 17th

The Gainwell Technologies Idaho Medicaid Provider Portal will be down from 7:00 to 8:00 PM MT on Tuesday, January 17, 2023, for an extended maintenance window. During this time, eligibility lookups will be available through our Medicaid Automated Customer Service (MACS) line at 1 (866) 686-4272. Thank you for your patience during our maintenance period.

1/17/2023 3:48 PM1/17/2023 3:48 PM1/17/2023
Provider Handbook Updates
Updates have been made to the Provider Handbook. You may find the link under the Reference Material menu on this website. Changes are noted in each document. The updated document is:
  • Behavioral Health and Social Services
1/11/2023 4:01 PM1/11/2023 4:01 PM1/18/2023
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