How We Help Medicaid Providers
As a healthcare provider in Wyoming, it’s essential to have access to secure and reliable information on the state’s Medicaid system. Luckily, Wyoming Medicaid has a Provider Home page that offers access to a range of essential resources for providers.
One crucial resource is the Secure Provider Portal, which is designed explicitly for Wyoming Medicaid providers. This portal offers a wide range of features, including claim submission, eligibility inquiry, PASRR Level I Entry and Inquiry, and more. In this article, we’ll discuss how to access the Secure Provider Portal and how to verify patient eligibility using Wyoming Medicaid’s resources.
Accessing the Secure Provider Portal
The Secure Provider Portal is the primary platform for Wyoming Medicaid providers to manage their Medicaid transactions. To access the portal, visit the Wyoming Medicaid Provider Home page and click on the “Secure Provider Portal” link.
Once you’ve arrived at the portal, you’ll need to set up a multifactor authentication (MFA) process for security purposes. If you’re a new provider, you’ll receive two letters in the mail with temporary ID and key information, which will allow you to complete the web registration process.
For more information on setting up the MFA process and accessing the portal, Wyoming Medicaid offers a Provider Portal Quick Start Guide and a Multifactor Authentication User Guide.
Using the Secure Provider Portal
Once you’re logged in to the Secure Provider Portal, you’ll have access to a variety of essential tools for managing Medicaid transactions. Here are some of the key features you’ll find within the portal:
- Claim Submission: Submit claims electronically and receive prompt responses to claim status inquiries.
- Eligibility Inquiry: Verify patient eligibility for Medicaid services.
- Prior Authorization (PA) Inquiry: Submit prior authorization requests for specific services.
- Remittance Advice (RA) Listing: Access detailed information on payments and explanations of benefits.
- Upload Files: Submit electronic files for payment and verification.
- View Provider Information: Access detailed information on your practice and services.
- Manage EDI Information: Manage your electronic data interchange (EDI) transactions.
- Manage Billing Agents and Clearinghouses: Manage third-party billing services.
- Manage SFTP User Account: Manage your secure file transfer protocol (SFTP) account.
In addition to these features, Wyoming Medicaid offers a range of resources and training materials on its website, including tutorials and workshops on using the Secure Provider Portal.
Verifying Patient Eligibility
Before providing services to a patient, it’s important to verify their eligibility for Medicaid services. Wyoming Medicaid offers a simple and efficient online tool for verifying patient eligibility.
To use the eligibility verification tool, visit the Wyoming Medicaid Provider Home page and click on the “Eligibility Inquiry” link within the Secure Provider Portal section. From there, you’ll be prompted to enter the patient’s Medicaid ID number and date of birth.
Once you’ve entered this information, the system will provide you with instant eligibility verification. This tool can help ensure that you’re providing services to eligible patients and avoid any issues with payment or reimbursement.
WYhealth…Get Plugged In! is a Total Population Health Management Program working with Medicaid providers to improve efficiency of care.
Radiology, Radiation Therapy, & Cardiology Services
Initiatives include the reduction re-admissions and emergency room utilization
Pre-Admission Screening and Resident Review (PASRR)