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:
• Dietary and Nutritional Services
• UB04 Instructions
The February Healthy Connections Member Rosters have been posted to your secure Trading Partner Account.
The February 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
The dates have been announced for the 2016 Idaho Health Care Conference. Click here for more information. Locations and dates are listed below.
IRS form 1099-MISC, Miscellaneous Income, for tax year 2015, will be mailed to providers before January 31, 2016. For more information, see our Frequently Asked Questions.
The Department will implement temporary rates for Residential Habilitation Agencies serving participants on the Developmental Disability Waiver effective for claims with dates of services February 1, 2016, forward. These temporary rates will be the reimbursement rates until a cost survey can be completed.
For more information and a list of the temporary reimbursement rates, please see Information Release MA16-01.
If a participant has primary insurance and their primary insurance claim has denied or paid at zero, providers must enter the Coordination of Benefits information in the COB Information section of the claim in addition to uploading the primary insurer's Explanation of Benefits (EOB). The EOB must include the EOB summary page. If the primary paid amount is zero, providers must enter zero and enter the paid date as the date of the EOB. If reporting both a co-pay amount and a coinsurance amount, these need to be added together and entered under coinsurance. These steps must be followed in order for us to process your claim correctly.
Effective February 1, 2016, Idaho Medicaid is restructuring the Healthy Connections and Health Home programs to incentivize primary care providers to transform their clinics into patient centered medical homes (PCMH). For additional information regarding these changes, please view the PCMH Frequently Asked Questions (FAQs) now available.
Effective January 19, 2016, participant information will appear differently when verifying Medicaid eligibility through the Molina Medicaid portal at www.idmedicaid.com or via phone to 1 (866) 686-4272. This is a result of changes being implemented to the Healthy Connections (HC) Program to incentivize primary care providers to transition to the Patient Centered Medical Home (PCMH) Model.
Please be sure to read the articles in the January 2016 edition of the MedicAide newsletter to find out more.
Effective February 1, 2016, IDHW is increasing the number of services that can be delivered via telehealth. In conjunction with this change, IDHW will no longer reimburse site fees for use of telehealth equipment. For more information, please see Information Release MA15-11 on the IDHW website.