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Wyoming Medicaid Providers                          STEPS TO ENROLL

The Care and Quality Solutions Group at Xerox (CQS) is partnered with the Division of Healthcare Financing to provide health management services to Medicaid clients. The program aims to positively impact clinical outcomes while reducing healthcare costs by improving care coordination and reducing unnecessary exacerbation of acute and chronic illnesses. Services provided by CQS include:

  • Utilization Management (UM) services for select medical procedures and admissions and full behavioral health admissions including Psychiatric Residential Treatment Facility (PRTF)
  • Health Management services including case management and care coordination.
  • A 24/7 nurse line
  • Healthy Habits weight management program
  • Appropriate ER Care Guidance program – focusing on Emergency Room usage
  • Health and Wellness program

This program is patient-centric and provides education, support and resources to help each person understand their health and healthcare needs. Telephonic and filed based Health Coaches work with clients to encourage them to be active participants in their health.

 

CQS understands the importance of provider and patient relationships. CQS encourages and promotes patients to have a primary healthcare provider or medical home. CQS staff may assist providers with additional support and education with patients outside of the provider office. In addition, case management/care coordination services are available for more complex Medicaid clients. It is easy to make a referral to the program. You may call 1-888-545-1710 or fax a Care Management Referral Form to 1-888-245-1928.

 

The CQS provider manual provides program descriptions and contains the Utilization Management forms, Inpatient Census Reporting (ICR) instructions, Case Management referral form, and additional instructions, processes, and services. The manual can be accessed at http://www.wyhealth.net/Provider_Manual.html. If you prefer to have a hard copy of the manual mailed to you directly, please call 1-888-545-1710 and request for a Provider Manual to be mailed to you at no cost.

 

For more information about the CQS Get Plugged In program, call 1-888-545-1710 or visit the website at http://www.WYhealth.net for further information.

 

Links:

WYhealth Get Plugged In

Forms and Brochures

Health Management and Utilization Management Program Brochure (Providers)

Care Management Program (Clients)

Care Management Referral Form

Health and Wellness Calendar

Provider Manual

24/7 Nurse Line