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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
    
December MedicAide Newsletter Now OnlineNew

The December edition of the MedicAide Newsletter is now available online. Please click here for the latest news and information affective Idaho Medicaid providers. If you must receive the MedicAide by mail, please dial 1(866)686-4272 and select option 3.  

Extended Maintenance Window December 5th through December 6thNew

​The Idaho Gainwell Technologies Provider Portal will be down from 11:00 AM MT Saturday, December 5th through 10:00 AM MT Sunday, December 6th for an extended maintenance window. During this time, eligibility lookups will be available through our Medicaid Automated Customer Service (MACS) line at 1(866)686-4272. Thank you for your patience during our maintenance period.

Portal Limitation Information

Gainwell Technologies was made aware that limitation information for eligibility and code look-ups on the provider portal were not working as expected. Our technical teams diligently worked to resolve this issue. Limitation and usage information for services such as therapy and DME, can again be validated on the provider portal.

For any questions, please send a Secure Message to us from your Trading Partner Account and include your NPI and inquiry.

Thank you for your patience while we worked to resolve this matter! 

Provider Enrollment Application Upgrade, System Unavailability and Training Opportunities

In preparation for the much-anticipated Provider Enrollment Application upgrade, the existing Idaho Medicaid Provider Enrollment Application (PEA) and system will be unavailable from 11/24/2020 through 12/06/2020 for the implementation of the upgraded product and system. Please note that this upgrade will not impact claim submission, processing or the financial cycle.

All new enrollment and maintenance requests will not be allowed during this time. All paper enrollment and maintenance requests will not be accepted and will be returned as the system will be inaccessible during this period. Please note that any new enrollment or maintenance requests that are unable to be submitted during this time will be considered for approval of a backdated effective date.

The upgraded Idaho Medicaid Provider Enrollment Application will feature a new look and feel, simplified processes for new enrollments and maintenance requests and feature dynamic screens and electronic signature options, which will result in quicker processing times and eliminate paper transactions.

Please start preparing for these upcoming changes by attending the upcoming training sessions. All upcoming training dates and times, along with topics and registration information can be found on the Training Calendar.

Thank you for your patience during this time, we look forward to sharing this upgrade with you!

Changes to our Assistance Processes
Immediate changes are being implemented by Gainwell Technologies with the support of the Idaho Department of Health and Welfare to ensure the highest level of security is reached. Gainwell is expecting providers to grant or authorize adequate levels of access to their respective staff, including billing agents or clearinghouses, to their Trading Partner Accounts for assistance with prior authorization status, claim submission, claim status details, payment reconciliation, and to perform secured messaging with Gainwell Technologies staff. 

The following changes can be expected immediately when contacting a Gainwell Technologies representative: 

  • Prior authorization status and details will no longer be provided or confirmed verbally over the phone. Prior Authorization status can be verified by logging into your secure Trading Partner Account or by utilizing the Telligen portal. 
  • Claim information, such as claim numbers, status, or payment details will no longer be provided or confirmed verbally over the phone. Claim status and payment information can be verified or obtained by logging into your secure Trading Partner Account. 
  • Claim denial information will no longer be researched and verbally provided over the phone. A secure message can be sent to Gainwell by logging into your secure Trading Partner Account. A response will promptly be provided within 1 to 2 business days. 
  • Remittance Advice (RA) details should be obtained through the secure Trading Partner Account. If a provider has elected for a paper RA and needs an additional copy, a secure message can be sent to Gainwell by logging into your secure Trading Partner Account requesting an additional copy of the RA.  
  • Electronic Funds Transfer (EFT), including banking details will not be discussed verbally over the phone. A secure message can be sent to Gainwell by logging into your secure Trading Partner Account, when necessary. 
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. 

 COVID-19
Official Resource for Novel Coronavirus(COVID-19) :
https://coronavirus.idaho.gov/resources-for-healthcare-providers
Information Releases :
/Lists/Information%20Releases/AllItems.aspx

 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 2020 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@dxc.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

 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@dxc.com.