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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
    
Attention Home Health and PCS Providers – What is EVV and how to prepare!

Electronic Visit Verification or EVV is an electronic system that is used to document services rendered. This is a mandatory requirement and must be used in order for Idaho Medicaid to allow claim payment for specific services.  Once a provider has selected their vendor, they will work directly with Sandata to report their chosen vendor and begin testing no earlier than mid-February.

Providers will be expected to complete a virtual self-paced training to prepare for the process of interfacing with Sandata. Technical Specifications have been established and outline the transmission data that is needed for the vendor to supply the necessary details in the EVV system. Providers will be asked to begin the testing process no earlier than mid-February.

For detailed and specific information related to the EVV requirements, testing, training, and preparing for production implementation select this link. 

Provider Enrollment Application - Provider Support

If you're experiencing an issue with navigating your application or if you're receiving an error message, please contact us by email at IDProviderServices@dxc.com or send secure message through your Trading Partner Account. Please include the following for an expedited resolution:

  • A detailed description of the question, issue or error that you've encountered
  • The username being utilized to access the Trading Partner Account
  • A screenshot of the issue or error
  • Pay-to NPI number and associated case number
  • If the issue is related to a rendering provider, include the rendering provider's NPI and name
  • If the issue is related to a license, Medicare Enrollment #, DEA, CLIA or Insurance update, include a copy of the credential

A response will be returned to your email message the same or next business day. If you'd prefer one-on-assistance to walk through your new enrollment or maintenance application, please contact your Provider Relations Consultant (PRC). As always, we're happy to provide general assistance over the phone at 1(866)686-4272, option 1 for provider enrollment. Thank you for your continued patience. 

Attention Home Health and PCS Providers
For any claims submitted with a date of service on or after 1/1/2021 you may see a new edit after submitting the claim. This edit will not affect claim payment at this time and will systematically be set to a WARN status. The purpose of this edit is related to the EVV implementation that is underway and additional communication will be provided when this edit will directly impact claims.

If this edit sets, it is to notify you that after implementation of the EVV solution, this claim will require matching EVV information. At this time the new edit is informational only and no action is required.

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.