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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
    
Healthy Connections Rosters

​The June 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 in each document. The updated documents are:
  • General Information and Requirements for Providers 
  • TPR Carrier Codes
Attention Personal Assistance Agencies and Home Health Agencies: EVV Claim Denials Beginning September 1,2021

COUNTDOWN: ONLY 11 WEEKS LEFT BEFORE EVV CLAIM DENIALS BEGINNING SEPTEMBER 1, 2021.

All EVV data must be reported and provided through your chosen and designated EVV vendor. Testing with your chosen and designated EVV vendor should be coming to completion to avoid claim denials beginning on SEPTEMBER 1, 2021. For more information on EVV, please visit: https://healthandwelfare.idaho.gov/providers/idaho-medicaid-providers/electronic-visit-verification-evv 

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 in each document. The updated documents are:

  • Hospital
  • Laboratory Services
  • Licensed Midwife
  • Physician and Non-Physician Practitioner
  • Suppliers
Hospital Length of Stay Authorization

​Concurrent and continued stay review authorization requirements will no longer be required for providers reimbursed under the DRG methodology starting July 1, 2021.  The concurrent and continued stay reviews will be replaced with retrospective DRG audits upon implementation of DRGs for those affected hospitals. 

More details related to this update will be made available in the future.

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. 
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 2021 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.