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Idaho Medicaid Health PAS OnLine

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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
    

 Prospective Providers and Enrollment
Welcome to the Gainwell Technologies 
provider portal for Idaho Medicaid Providers


We are thankful for your interest in participating with the Idaho Medicaid program. To enroll with Idaho Medicaid, providers are required to complete registration for a Trading Partner Account and then complete the electronic Provider Enrollment Application. The Trading Partner Account can be utilized, once fully enrolled, to verify participant eligibility, view and submit claims, get important announcements, access the provider handbook and more!


To access resources to support you in the enrollment process, follow this link If you need additional assistance, please contact us Monday through Friday from 7:00 AM to 7:00 PM MST.

 Welcome

Welcome to the Idaho Gainwell Technologies 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. Click here to sign in to your secure Trading Partner Account. Once logged into the secure portal, you can perform enrollment and maintenance, view eligibility and authorizations, view and submit claims, download reports, and more.

 ‭(Hidden)‬ Provider Enrollment Information

Enrollment Instructions for Independent Intervention Specialist and Professional Providers
Enrollment Instructions for Independent Respite and CBS Providers
Maintenance User Guide – Facility Agency Organization
Maintenance User Guide – Group
Maintenance User Guide – Individual
New Provider Enrollment User Guide – Converting from an ORP to an Individual Provider
New Provider Enrollment User Guide – Facility Agency Organization
New Provider Enrollment User Guide – Group
New Provider Enrollment User Guide – Individual
New Provider Enrollment User Guide – Ordering Referring Prescribing Provider (ORP)
PEA Top Issues
PEA Top Tips and Tricks
Prospective Provider Toolkit – Personal Assistance Agency
Provider Enrollment User Guide – Disenrollment
Provider Enrollment User Guide – Reactivation
Healthy Connections Rosters
9/10/2024 10:56 AM
Claims Processing Reminder/Clarification – Participants with Other Insurance
9/5/2024 5:19 PM
September MedicAide Newsletter Now Online
9/3/2024 3:58 PM
Phone System Intermittently Unavailable
9/3/2024 12:52 PM
Day Holiday and the Financial Cycle
8/27/2024 3:59 PM
DMEPOS and Therapy Provider Meetings
8/26/2024 12:55 PM
Update on Denied Claims with a Behavioral Health Diagnosis
8/22/2024 12:04 PM
Provider Handbook Updates
8/21/2024 8:42 PM
Healthy Connections Rosters
8/12/2024 10:29 AM
Edit 407 – Modifier(s) is invalid for Medical Policy Denials
8/8/2024 3:34 PM
Update! DEA Credential is NOT Required for Pharmacists
8/1/2024 5:35 PM
Enhancement to Pharmacist Providers – Enrollment and Billing Changes
8/1/2024 5:26 PM
Elimination of Paper Enrollments
8/1/2024 5:24 PM
August MedicAide Newsletter Now Online
8/1/2024 5:24 PM
Provider Handbook Updates
8/1/2024 5:04 PM
Edit 6053 IBHP Coverage/Submit claim to MCO Denials
8/1/2024 4:56 PM
Resolved - Phone System Unavailable
7/31/2024 8:52 AM
Phone System Unavailable
7/30/2024 4:15 PM
Potential Power Outages in our Local Area
7/24/2024 4:39 PM
Crowdstrike Incident
7/19/2024 9:05 AM
Phone System Intermittently Unavailable
7/19/2024 8:51 AM
Phone System Unavailable
7/19/2024 7:54 AM
Healthy Connections Rosters
7/15/2024 8:35 AM
Payment Delay
7/10/2024 2:23 PM
Now Available! e-Learning Series – Provider Enrollment Application
7/1/2024 4:56 PM
July MedicAide Newsletter Now Online
7/1/2024 4:49 PM
Holiday and the Financial Cycle Impacts
7/1/2024 4:44 PM
Provider Handbook Updates
7/1/2024 8:20 AM
Payment Delay
6/26/2024 9:59 AM
Timely Filing Exception for Eligibility Changes
6/20/2024 3:57 PM
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 ‭(Hidden)‬ COVID-19
Official Resource for Novel Coronavirus(COVID-19) :
https://coronavirus.idaho.gov/resources-for-healthcare-providers
Information Releases :
/Lists/Information%20Releases/AllItems.aspx

 Reminder or Tip from Gainwell

Did you know that you can refer to the Remittance Advice Analysis and Top Claim Denial Reasons reference materials as resources that may better explain how to interpret the remit details and the reason a claim was denied? We encourage all providers to familiarize themselves with the Remittance Advice and any claim denial; providers only have two years from the start date of service to make corrections or adjustments to their claims. 

 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. 

 ‭(Hidden)‬ 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. 

 ‭(Hidden)‬ Gainwell Technologies Partners
Click here for a list of contact information for our valued partners. 
Attention! Behavioral Health Providers

​If you are a provider who is enrolling or enrolled as a Mental Health Clinic, Rehabilitative Mental Health Service provider, Mental Health Case Management provider or any other provider that renders behavioral health services, you may also be required to enroll and maintain your provider record with Optum Idaho. For more information, contact Optum. Regional Network Managers can assist you and are listed on the Regional Representation Flyer found at www.OptumIdaho.com > Contact Us tab. 

 Idaho Medicaid Member Resources
​Participant Services Phone ​1 (866) 686-4752 (Toll-free), 1 (208) 373-1432 (Local)
​Participant Services E-mail ​idparticipantservices@gainwelltechnologies.com
​Participant Information Website https://healthandwelfare.idaho.gov/services-programs/medicaid-health
​Language Services ​http://healthandwelfare.idaho.gov/AboutUs/LanguageAssistance/tabid/3766/Default.aspx
​Idaho Health Plan Coverage Booklet - English ​ https://publicdocuments.dhw.idaho.gov/WebLink/DocView.aspx?id=2080&dbid=0&repo=PUBLIC-DOCUMENTS
​Idaho Health Plan Coverage Booklet - Spanish ​ https://publicdocuments.dhw.idaho.gov/WebLink/DocView.aspx?id=2081&dbid=0&repo=PUBLIC-DOCUMENTS

 Gainwell Technologies Contacts
​Gainwell Provider Relations Consultants Contact Information
​Idaho Medicaid Contact Information (Provider Services, Provider Enrollment, and Gainwell partners)

 

 Resources & Links
Provider Handbook
​MedicAide Newsletters
​Medicaid Fee Schedules
​User Guides
​Information Releases

 

 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 2024 Financial Payment Processing Cycles.
 

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@gainwelltechnologies.com.

 

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