Online Help Help

  • Idaho Medicaid Program
    Health Coverage
    for Idaho families
  • Idaho Medicaid Program
    Health Coverage
    for Idaho families
  • Idaho Medicaid Program
    Health Coverage
    for Idaho families
    
President's Day Holiday and the Financial Cycle

​Due to the President's Day holiday, the financial cycle for the week of 2/15/2019 will be delayed by one day. Payments, Remittance Advices (RAs), and the HIPAA 835 Claim Advice Files will be one day later than normal.

Healthy Connections Roster

​The February Healthy Connections Rosters have been posted to your secure Trading Partner Account.​​​​​​​

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 at the beginning of each document. The updated documents are:

  • TPR Carrier Codes
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. If you must receive the MedicAide by mail, please dial 1 (866) 686-4272 and select option 3.​​​​​​

WE WANT YOUR INPUT!

​Where do you go to find information about Medicaid? What information do you find most useful? Please take the short survey and provide your feedback. We will use your feedback to ensure we are communicating with you in the best way possible. The survey will be available through March. We look forward to hearing from you!

Billing with Modifier 51

The primary CPT code should be billed as the first service line on the claim. Additional services(s) should be billed on subsequent lines with modifier 51 appended, as appropriate. This rule applies to multiple surgeries, and multiple births.

When processing claims with an appended 51 modifier, the Idaho Medicaid Management Information System (MMIS) will only consider paid lines as the primary surgical procedure. What does this mean? If the primary service is denied for any reason, the system will look at the secondary service billed, and ignore the modifier 51 designation in order to process the services.

Additionally, the MMIS reviews the billed amount of services to help determine the order in which services should be priced. If the primary CPT code and secondary CPT code are the same billed amount, the services should be billed in a manner that differentiates the primary service and secondary service, in addition to the 51 modifier.

For more information relating to reimbursement or billing guidelines for modifier 51, please refer to the article titled, Medicaid Program Integrity Unit, Reimbursement Reminder for Physicians and Mid-level Providers published in the December 2018 MedicAide Newsletter.

Attention Providers Submitting Secondary Claims through Your Trading Partner Account

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.

Dial 1 When You Call!
It is very important that you dial a 1 when calling us. Please call 1 (866) 686-4272.  Thank you!
Welcome to the Idaho DXC Technology Online Portal for Medicaid Providers!


This website provides information to Idaho Medicaid providers, trading partners, and the public. Helpful documents and links can be found in the menu bar above. 

 Scheduled System Downtime

​The Idaho Medicaid website is down each week from 4 PM on Saturday to 10 AM on Sunday for regular maintenance.  During this time, eligibility inquiries are available through our telephone system at 1 (866) 686-4272.  Any changes to this standard maintenance window will be communicated via an announcement on this website. 

 Claims Processing


Paper claims must be received by 5:00 P.M. Monday in order to be included in the next regular weekly payment processing cycle.

Electronic claims must be received by 8:00 p.m. Thursday to be included in the next regular weekly payment processing cycle.

Click here to view the 2019 Financial Payment Processing Cycles.

 Trading Partner Account Login

Click here to sign in to your secure Trading Partner Account.  By logging into the secure portal, you can view eligibility, view and submit claims, manage patient rosters, perform enrollment and maintenance, view authorizations, download reports, and more. 

 DXC Technology Partners

Click here for a list of contact information for our valued partners. 

 Idaho Medicaid Member Resources

​Participant Services Phone​1 (866) 686-4752 (Toll-free), 1 (208) 373-1432 (Local)
​Participant Services E-mailidparticipantservices@molinahealthcare.com
​Participant Information Websitehttp://www.healthandwelfare.idaho.gov/Home/tabid/55/Default.aspx
​Language Serviceshttp://healthandwelfare.idaho.gov/AboutUs/LanguageAssistance/tabid/3766/Default.aspx

 Molina Contacts

DXC Technology Provider Relations Consultants Contact Information
Idaho Medicaid Contact Information (Provider Services, Provider Enrollment, and DXC Technology partners)

 

 Resources & Links

 

Provider Training
Opportunities

Click here to view the Training Calendar and browse upcoming training opportunities.  Please log into the Idaho Medicaid Training Center to register for training sessions. 

For training support, contact IDTraining@MolinaHealthcare.com.