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  • Idaho Medicaid Program
    Health Coverage
    for Idaho families
  • Idaho Medicaid Program
    Health Coverage
    for Idaho families
  • Idaho Medicaid Program
    Health Coverage
    for Idaho families
    
Healthy Connections Rosters

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

October MedicAide Newsletter Now Online

​The October 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.​​​​​​

Idaho Medicaid Plus (IMPlus)

​Effective November 1, 2018, a new program called Idaho Medicaid Plus (IMPlus) will be available to dual eligible participants in Twin Falls County. This program will be mandatory for dual eligible participants who have not elected to enroll in the Medicare Medicaid Coordinated Plan (MMCP) and are not in an excluded population. Providers are encouraged to be contracted with Blue Cross of Idaho and Molina Healthcare of Idaho to ensure prompt processing of claims. For additional information please go to www.truebluesnp.com for Blue Cross of Idaho and www.molinahealthcare.com for Molina Healthcare of Idaho. You can also find additional information on the IMPlus Program at MMCP/IMPlus.

DXC Technology Purchased Molina Medicaid Solutions

Effective October 1st, 2018, DXC Technology has purchased Molina Medicaid Solutions. We are excited about the opportunity for our company to forge new pathways to healthcare innovation and improve the quality of services to individuals and providers. DXC Technology will work closely with Molina Medicaid Solutions and IDHW to ensure daily operations will not be impacted due to this transaction. For more information, please see the related press release or refer to the FAQ's.

Home Health Providers – Homebound Not Required

​Although Medicaid follows many of Medicare’s guidelines, Idaho Medicaid does not require participants to be homebound to receive home health services.

Epidural Anesthesia Billing Time

Obstetrical neuraxial anesthesia/epidural, CPT 01967 for vaginal delivery time, is not counted like general anesthesia time. Obstetrical epidural time is counted in minutes from beginning to end even if the anesthesiologist is not physically in the room. This is allowed because the anesthesiologist may attend more than one patient concurrently under continuous epidural analgesia for obstetrical deliveries.

When billing obstetrical anesthesia, indicate total time in minutes for CPT 01967. The Idaho Medicaid Management Information System (MMIS) will calculate the claim payment based on minutes.

Intra-Agency Agreement for Early Intervention Services

The Infant Toddler Program and Idaho Medicaid launched a new model for early intervention services under Early Periodic Screening and Diagnostic Services (EPSDT), effective July 1st for children (ages birth up through 36 months) eligible for Medicaid, who have a development delay or who are at risk of developing a developmental delay, to receive medically necessary screenings.   The Intra-Agency Agreement for Early Intervention Services  which supports the agreement between the Division of Family and Community Services and the Division of Medicaid is now available in the Links section of the Provider Handbook under the Resources tab on the Molina Medicaid Provider Portal. Guidance for providers is available in the General Provider and Participant Information handbook, in the Early Intervention Services section.  You can also find more information in the June edition of the MedicAide Newsletter.

PERM Audit - Improper Payments to be Recouped

Have you received a request for records from the Payment Error Rate Measurement (PERM) program? This program measures improper payments in Medicaid; auditors must review medical records. If providers do not submit the medical records requested by PERM auditors, the claim payment will be considered an improper payment. Without the requested records there is no evidence for auditors to determine whether the services were provided, were medically necessary and were properly coded and paid. Idaho Medicaid must recover any improper payments made to providers.

Failure to provide requested documentation for claim payments is a violation of Idaho Code Section 56-209h and the Idaho Medicaid Provider Agreement. Providers contacted by PERM auditors must respond with the requested records in the timeframe indicated.

For more information about PERM, please see the June 2018 MedicAide newsletter or our Frequently Asked Questions at: https://www.idmedicaid.com/Lists/FAQs/Current.aspx.
 

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 Molina 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 Molina 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 2018 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. 

 Molina 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

Molina Provider Relations Consultants Contact Information
Idaho Medicaid Contact Information (Provider Services, Provider Enrollment, and Molina 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.