Enroll as a Wyoming Medicaid Provider
Steps to Enroll
In Wyoming, the Medicaid Program is administered by the Wyoming Department of Health, Division of Healthcare Financing, Office of Medicaid. We are pleased to report that the majority of Wyoming physicians participate in Medicaid and we encourage you to enroll. The Department contracts with Xerox, Inc. to operate our claims processing and reporting system.
Steps to enroll:
1. Contact Xerox Provider Relations at 1-800-251-1268 to request an enrollment form and provider agreement or you may download the forms from the ACS website at https://wyequalitycare.acs-inc.com/wy/general/providerEnrollmentHome.do
2. Xerox will assign a provider billing number and will supply required billing information. Fee schedules are published on the web site.
3. Xerox will arrange a provider visit with your office staff upon request to review billing requirements.
Electronic billing is available and questions regarding enrollment of claims processing should be directed to Xerox. Questions regarding Medicaid or reimbursement which are not directly related to claims processing should be directed to the Division of Healthcare Financing, Office of Medicaid at 307-777-7531.
If you have questions regarding your billing or enrollment, contact Xerox Provider Relations at 1-800-251-1268 or check out our Frequently Asked Questions below.
Wyoming Medicaid Provider Manuals are also found on the Wyoming Medicaid website.
Frequently Asked Questions by Providers
Q: How do I get a code covered by Medicaid?
A: A provider may contact Xerox, Inc. in writing with a request to cover any code not covered. This request must include a complete description of the item or services, the code or codes you wish to have covered, and the appropriate modifiers. You may mail this to Xerox, Inc., Provider Relations Unit, P.O. Box 667, Cheyenne, WY 82003-0667.
Q: How do I know what codes to use when billing for a service, equipment, or supplies?
A: The American Medical Association publishes two coding manuals each year. They are the Current Procedural Terminology CPT, and the Healthcare Common Procedure Coding System “HCPCS (pronounced hick picks).” Use these manuals to help you identify the correct codes for billing your services. Xerox, Inc. and the Division of Healthcare Financing, Office of Medicaid cannot advise you on which codes to use.
Q: How do I find out if Medicaid covers a procedure?
A: There are two methods you can use to find this information. First, click on Fee Schedule here. The fee schedule lists all the codes for medical procedures, equipment, and supplies covered by Medicaid. Each code is assigned a fee and effective date. If your code is not listed, it may not be covered by Medicaid. The second method is to call Provider Relations at 1-800-251-1268 and ask if your specific code is covered.
Wyoming Medicaid PRTF Incident Report
Wyoming Medicaid PRTF Incident Report – Please make sure your internet connection is secure by checking that the displayed URL begins with “https://”.
The following list of incidents involving Wyoming Medicaid clients require the use of this form to report to the State of Wyoming Department of Health and WYhealth by Optum within one business day of the incident. This incident report does not replace or change any other reporting requirements that apply.
• Physical or sexual assault
• Injury or illness that requires medical attention, including caused by restraint
• Medication error requiring medical attention
• Involvement of law enforcement, outside of WY DFS/probation
• Harm to self-requiring medical attention
• Fire or other disaster affecting client’s living or treatment situation
• Elopement or abduction
• Illegal substance use while on facility grounds or on a facility supervised trip
• Pregnancy if not known at time of admission
• Discharge to the wrong facility
If a correction action plan or root cause analysis results from this incident, please fax this as it is completed to WYhealth Fax: 888-245-1928.