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Idaho Medicaid Health PAS OnLine

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
    
Medicaid Expansion

If you are a provider or participant seeking information on Idaho Medicaid Expansion, please visit the Medicaid Expansion site. Helpful information related to the application process, waiver information, FAQs and much more is available NOW!

Medicaid Participant Eligibility

Idaho Medicaid participant eligibility is determined annually. Many re-determinations occur in December. Failure to respond to the re-determination with the necessary information could result in the loss of Medicaid benefits.

Medicaid Participants: Please respond to any requests from the Idaho Department of Health and Welfare for information to determine Medicaid eligibility. If you have questions regarding your Idaho Medicaid eligibility, please contact the Idaho Department of Health and Welfare at 1-877-456-1233.

Medicaid Providers: Please continue to check Medicaid eligibility prior to rendering services, as outlined in the Idaho Medicaid Provider Handbook, General Provider and Participant Information, section 1.3.8 titled Verifying Participant Eligibility. If you have questions regarding eligibility verification, please contact your DXC Provider Relations Consultant or DXC Technology at 1(866)686-4272.

Healthy Connections Rosters

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

December MedicAide Now Online

The December 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. ​

Coordination of Benefits (COB)

In September of 2019 DXC Technology in partnership with Idaho Medicaid implemented COB Phase 3 into the Medicaid Management Information System. The Trading Partner Account (TPA ) User Guide, section titled Coordination of Benefits (COB) Information has been updated to reflect current functionality.

This implementation added functionality for coinsurance and copayment reporting when submitting secondary claims. It is critical for accurate coordination and processing that these details are reported accurately.

When adjusting a secondary claim through the Portal, the COB details should be validated before submitting the claim, to ensure the detail that was initially submitted is correct.

Seven (7) Coordination of Benefit trainings will be held at various times during the month of December. Please see the Training Calendar for the dates and times, and visit the Idaho Medicaid Training Center to register for a course. If you need any assistance with registering, email IDTraining@MolinaHealthCare.Com.  

Reminder to Providers

Reminder to Providers that are contracted with a 3rd party entity for billing or claims support

Providers are expected to grant or authorize adequate levels of access to their respective Billing agent or Clearinghouse. Specifically, when they are assisting with claim submission and reconciliation.

For your convenience please see the following list for access and resources:

• Create an association between the Provider’s Trading Partner Account (TPA) and the 3rd parties TPA. This will provide the entity with access to the claim and payment information 24/7. In addition, It grants the user ability to correct or submit a claim electronically. (Instructions can be found in the Trading Partner Account Registration and Maintenance Guide> Manage Billing Agent Association.)
• Route the 835 file directly to the Clearinghouse or Billing Agent (Instructions can be found in the Trading Partner Account Registration and Maintenance Guide> 835 Routing.)
• Remind the Clearinghouse or Billing Agent of payment cycle changes, which can be found in the Announcements.  
• Provide your 4-digit Security Code to the Clearinghouse, Billing Agent and internal users needing to access the interactive voice recognition system. This is available 24/7 and eliminates hold times to reach a Call Center Professional.
• For our shared efficiency, please ask your Clearinghouse or Billing Agent Representatives to be prepared to provide verifying information when they call.

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-mail​idparticipantservices@molinahealthcare.com
​Participant Information Websitehttp://www.healthandwelfare.idaho.gov/Home/tabid/55/Default.aspx
​Language Services​http://healthandwelfare.idaho.gov/AboutUs/LanguageAssistance/tabid/3766/Default.aspx

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

 

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

 
 

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.