Welcome to Medicaid
Medicaid is a joint federal and state government program that pays for medical care for some low income and medically needy individuals and families.
CQS/Xerox - This link directs you to the CQS/Xerox's health and utilization management programs for Wyoming Medicaid. Helpful information for providers, stakeholders, clients and families. This website is currently being updated. Please check back at a later date.
Eligibility - This link directs you to information on who may be eligible for Medicaid and how to apply can be found on our eligibility page
Xerox Medicaid Provider/Client Portal - This link directs you to the Medicaid/ACS provider and client portal. Providers can check status of claims, benefits, and services. Clients can check eligibility or benefits and to request a replacement Medicaid ID Card or Transportation Services.
HIPAA 5010 Transition – Beginning January 1, 2012, all electronic data interchange (EDI) transactions must be in the new X12 5010 format. The new standards will yield greater accuracy and efficiency of eligibility, billing, claims processing, reimbursement, and will be able to accommodate the mandatory ICD-10-CM and ICD-10-PCS code sets which are scheduled to be implemented on October 1, 2013. This link directs you to the Medicaid/ACS provider portal to learn more and what you can do so that your provider payments are not in jeopardy.
Health Check - This link directs you to our Health Check page which lets you know, what health check is, a Health Check brochure, the Health Check newsletter and other publications.
Home Care Services - This link directs you to a Medicaid program that provides nursing or therapy services to persons in their homes under a physician's plan of care.
Partnership Access Line (PAL) NEW - Medicaid is pleased to be able to provide new resources for Providers providing care to our children, and also all of our clients with Developmental Disabilities. Please go to www.wyomingpal.org where you can find how to have a free consult with a Child/Adolescent psychiatrist on any patient you may be seeing, and also a valuable link to Resources for Wyoming providers in the Primary Care Principals for Child Mental Health.
- Enroll as a Wyoming Medicaid Provider
- Provider FAQ
- In June 2009 Medicaid Moved to a new AVR/IVR Automated Voice Response/Interactive Voice Response) System. See the following bulletin for detailed information on this system: AVR/IVR System Improvements
- WYhealth...Get Plugged In
- Pulse of CMS
- The Division of Healthcare Financing has established a new email address specifically for Medicaid Providers to use to submit comments, concerns, complaints and compliments. Emails may be sent to: HCFProviders@health.wyo.gov
- The purpose of this process is to solicit input on everything that happens in our program, and more specifically, current concerns. At this time, the significant issues that impact our program and providers center around reimbursement reduction and changes arising from the budget shortfalls. We understand that rate adjustments may have a considerable effect on medical professionals who provide services to Medicaid clients and want to keep lines of communication open for comments they wish to share.
- As we go forward and continue to look for ways to reduce costs and still maintain access to healthcare, we welcome any recommendations that our providers may have. The Department will research proposals and implement ideas which reduce duplicative or inefficient care and utilization.
Provider Information - Updates
- Public Notice - CHIP Chapters 1-4 - Effective January 20, 2014
- Public Notice - SPA 13-009 - Ambulatory Surgical Centers - Effective February 1, 2014
- Bulletin - Provider Exclusion Lists - Providers participating in Federal programs are obligated to screen all employees and contractors to determine whether any of them have been excluded. This screening should take place upon hiring of a new staff person and monthly thereafter on all staff to check for any new additions to the exclusion list. If any exclusionary information is discovered, it should be reported to ACS and/or BCBS imme
- Wyoming Provider Exclusion List - please contract Amy Guimond at 777-5609
Proposed Medicaid Rules Changes
Recovery Audit Contract (RAC) Training Materials