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 ‭(Hidden)‬ Welcome to Health PAS OnLine



 Welcome to Health PAS-OnLine Announcements

Thanksgiving Day Holiday and the Financial CycleUse SHIFT+ENTER to open the menu (new window).

Due to the Thanksgiving holiday, electronic claims must be received by 8:00 p.m. Tuesday, November 24, in order to be included in the next regular weekly payment cycle.

Healthy Connections/Health Home Member RostersUse SHIFT+ENTER to open the menu (new window).

The November Healthy Connections and Idaho Medicaid Health Home Member Rosters have been posted to your secure Trading Partner Account.

Coordination of Benefits NewsUse SHIFT+ENTER to open the menu (new window).

Changes in COB claims processing will begin with claims submitted on or after December 1, 2015 and will have a limited impact to most providers.


The first of three phases of COB claims processing improvements will simplify COB claim pricing.


All COB claims will be priced in one of three ways:


1.  Member Responsibility

The primary payers’ coinsurance, copay, and deductible.


2.  Medicaid Allowed Amount Minus Primary Insurance Payment

Medicaid will pay up to our allowed amount.


3.  Lesser Of  

Medicaid will pay whichever result is less Member Responsibility or Medicaid Allowed Amount Minus Primary Insurance Payment. 


In phases two and three we will improve accuracy and timely resolution of COB claims adjudication and decrease claim denials. 


For more detailed information regarding these changes, please refer to the Coordination of Benefits Reimbursement Alignment article published in the November 2015 MedicAide.

November MedicAide Newsletter Now OnlineUse SHIFT+ENTER to open the menu (new window).
The November 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.
Outpatient Billing of Physician Administered Drugs (PADs)Use SHIFT+ENTER to open the menu (new window).
Reminder to Outpatient Hospital Providers who bill for physician-administered drugs (PADs): Idaho, by federal regulation, must collect NDCs for PADs.  Hospital outpatient providers must bill all PADs with revenue code 0636, along with the applicable HCPCS code (Healthcare Common Procedure Coding System) and the National Drug Code (NDC). 
Physician-administered drugs may not be billed using revenue code 0250 to bypass the requirements for collection of the NDC.  
ICD-10 Compliance Now in EffectUse SHIFT+ENTER to open the menu (new window).

ICD-10 diagnosis codes are now required on ALL claims with a date of service of 10/1/2015 and later.  ICD-9 diagnosis codes continue to be required on ALL claims for dates of service of 9/30/2015 or earlier. 

FQHC/RHC Crossover and Third Party BillingUse SHIFT+ENTER to open the menu (new window).
In order to be paid up to the Encounter Rate for claims with a third party payment, specific instructions must be followed. Click here for the instructions.
Dial 1 When You Call!Use SHIFT+ENTER to open the menu (new window).
It is very important that you dial a 1 when calling us. Please call 1 (866) 686-4272.
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