Provider Home | Serving Wyoming Medicaid Providers and Members (2024)

ALL COVID-19 INFORMATION HERE

Welcome to Wyoming Medicaid’s Provider Home. On this primary page, providers will find information and links to important areas such as the Secure Provider Portal, Notice of Privacy Practices, Scheduled Provider Portal Downtimes, and more. For more information regarding the new Wyoming Medicaid website, please click Wyoming Medicaid Website Quick Start Guide.

Secure Provider Portal

The secure Provider Portal is specifically for Wyoming Medicaid Providers and is tailored to secure provider transactions and needs. For more information regarding the secure Provider Portal, please click Provider Portal Quick Start Guide. Within the Provider Portal, providers can find information on each of the following key items:

Ask MedicaidClaim Submission
Claim Status InquiryElectronic Claim Attachment
Eligibility InquiryLT101 Inquiry
PASRR Level I Entry and InquiryPA (Prior Authorization) Inquiry
RA (Remittance Advice) ListingUpload Files
Manage Provider
  • View Provider Information
  • Manage EDI Information
  • Manage Billing Agents and Clearinghouses
  • Manage SFTP User Account

Note: Current and returning providers can access the secure Provider Portal above or directly within the Provider Tab.

Multifactor Authentication Required

A required multifactor authentication (MFA) must be set up by all providers. More information regarding this specific MFA setup as well as an MFA User Guide are both available to assist in this setup process.

Please click for more information regarding this login requirement. In addition, please click Multifactor Authentication User Guide for the process and steps involved with setting up this required MFA.

Web Registration for New Pay-to Providers

Welcome newly-enrolled Wyoming Medicaid Pay-to Providers. Once the Benefits Management System and Services (BMS) has received a new provider’s file, the following will occur:

  • Two (2) letters will be generated and sent to a provider’s on-file mailing address.

    Note: Allow 7-10 business days from the HHS approval date.

    • Welcome Letter (Temporary ID)
    • Security Letter (Temporary key)

Upon receipt of these two letters, providers can proceed with the required web registration process. It is recommended that providers use the available web registration trainings located on the Provider Trainings and Tutorials webpage.

Note: If providers need to be associated with an existing Pay-to provider, contact that provider’s office to complete the association. For questions, contact Provider Services at 1-888-WYO-MCAD (1-888-996-6223).

New Billing Agent/Clearinghouse Enrollment

New BAs/CHs must first complete the required enrollment process with Wyoming Medicaid. Click BA/CH Enrollment to enroll as Billing Agent/ Clearinghouse Provider.

Click the BA/CH Enrollment Tutorial for instructions on how to enroll as a BA/CH with Wyoming Medicaid.

Note: If you were previously enrolled as a BA/CH with Conduent’s EDI Services you should have received the two (2) web registration letters, if not, contact Provider Services at 1-888-996-6223 for assistance. For steps on completing the web registration, please review the Web Registration – Billing Agents & Clearinghouses (BA & CH) presentation or recording located on the Provider Training, Tutorials and Workshops page.

Single Sign On Updates

Click Single Sign On to update SSO details. In addition, please click Provider SSO Registration User Guide for more information.

Within the SSO page, you can change the following SSO details:

  • Change password
  • Display preferences
  • User preferences
  • Add/Remove Tabs
  • Group Application Tiles

Payment Exceptions

The Payment Exceptions document lists out, in table format, the following key dates regarding payments:

  • Wyoming Medicaid Payment Dates
  • State Auditor’s Payment Dates
  • Electronic Fund Transfer (EFT) Transmit Dates
  • Check Mail Dates
  • Remittance Advice (RA) and 835 Dates

Scheduled Website and Portal Downtimes

The following table displays scheduled downtimes and related impact areas for the Wyoming Medicaid website, secure Provider Portal, and secure Member Portal:

Impacted SiteImpact AddressJustificationDowntime Window
Medicaid WebsiteEntire Website (Provider/Member areas and all static content)Scheduled Maintenance

1 am - 3 am MST

Provider PortalClaims Submission Verification UnavailableScheduled maintenance1 am - 3 am MST
myHealthPortalEntire WebsiteScheduled maintenance1 am - 3 am MST
Important Notes:

Only Prior Authorizations processed by Medical Policy are eligible to be submitted through the Secure Provider Portal. For all other authorizations, please refer to Chapter 6 of the provider manual for the table of services for contact information.

Before submitting 278 electronic files, providers, billing agents, and clearinghouses should contact EDI Services to ensure their Trading Partner ID is setup to specifically submit and receive 278 transactions.

Notice of Privacy Practices

The following documents describe how your information may be used and disclosed. It also details how you can acquire access to this information

  • Notice of Privacy Practices English (64K)
  • Notice of Privacy Practices Spanish (57K)

Fraud Schemes Targeting Native American Communities in Behavioral Health Treatment Centers

The U.S. Department of Health and Human Services Office of Inspector General (OIG) is alerting the public about fraudulent activities aimed at members of Native American communities in relation to behavioral health outpatient treatment centers (OTCs). For more information regarding these fraud schemes, please visit this fraud scheme notification.

Provider Home | Serving Wyoming Medicaid Providers and Members (2024)

FAQs

What is the Wyoming Medicaid number for providers? ›

You can contact Provider Services at 1 (888) WYO-MCAD or 1-888-996-6223. If you have questions regarding billing Wyoming Medicaid for services rendered, you can utilize the Wyoming Medicaid website located at: https://wyomingmedicaid.com/ or contact Provider Services at 1 (888) WYO-MCAD or 1-888-996-6223.

What is the income limit for Wyoming Medicaid? ›

Who is eligible for Wyoming Medicaid?
Household Size*Maximum Income Level (Per Year)
1$20,030
2$27,186
3$34,341
4$41,496
4 more rows

What is Wyoming Medicaid called? ›

Wyoming Medicaid Health Management (WYhealth)3. WYhealth - Health Center. National, State, & Community Resources.

Who is the fiscal agent for Medicaid in Wyoming? ›

CNSI, as the Fiscal Agent for Wyoming Medicaid, processes all claims and adjustments.

How do I check my Medicaid status in Wyoming? ›

myHeathPortal – This is the secure Member Portal maintained by Wyoming Medicaid, whereby members can check their eligibility, request a Wyoming Medicaid Benefits ID card, submit a transportation request, and more.

How long does it take to get Medicaid in Wyoming? ›

Applications received through the Wyoming Eligibility System (WES) on-line (www.wesystem.wyo.gov) or via the phone (855-294-2127) generally are processed in a shorter time frame than the applications received via mail. Applications can take up to 45 days to process.

What is the most money you can make on Medicaid? ›

Who is eligible for California Medicaid?
Household Size*Maximum Income Level (Per Year)
1$20,030
2$27,186
3$34,341
4$41,496
4 more rows

What is the highest income to qualify for Medicaid? ›

Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Eligibility limits for single adults without dependent children are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

What is the income limit for Medicaid in Wyoming in 2024? ›

Wyoming seniors must have limited income and assets, and a medical need to qualify for Medicaid long-term care. In 2024, a single Nursing Home Medicaid applicant must meet the following criteria: 1) Income under $2,829 / month 2) Assets under $2,000 3) Require a Nursing Home Level of Care.

Does Wyoming have expanded Medicaid? ›

A Medicaid expansion bill that passed the Wyoming House for the first time subsequently failed a vote in the Senate Labor, Health, and Social Service Committee in March 2021.

Does Wyoming Medicaid work in other states? ›

A: No. You cannot transfer Medicaid from one state to another. Each state's Medicaid programs are different. You must submit a new application in Wyoming.

How many people are on Medicaid in Wyoming? ›

As of April 2023, more than 84,000 people were enrolled in Medicaid/CHIP programs in Wyoming, and all of them will need to have their eligibility rechecked during the unwinding period. Wyoming's April 2023 enrollment was 25% higher than enrollment had been in 2013.

How is Wyoming Medicaid funded? ›

Medicaid is funded as a federal-state partnership.

Is Medicaid totally financed by the federal government? ›

Medicaid is administered by states within broad federal rules and jointly funded by states and the federal government through a federal matching program with no cap.

How does a fiscal agent work? ›

Fiscal agents are financial institutions or other third parties receiving remittances and/or making disbursem*nts on behalf of the state. The state's normal procedures for receipts and disbursem*nts should be used whenever possible to minimize the use of fiscal agents.

What is the number for Medicare in Wyoming? ›

1-800-MEDICARE (1-800-633-4227)

For specific billing questions and questions about your claims, medical records, or expenses, log into your secure Medicare account, or call us at 1-800-MEDICARE.

Does Wyoming have Medicaid? ›

Wyoming Medicaid is a joint Federal-State program that pays for the medical care of low-income and medically-needy individuals and families.

How do I get a Medicaid provider number in Oregon? ›

National Provider Identifier (NPI) requirements

OHA cannot enroll new providers without this number. To get an NPI, apply online at the National Plan and Provider Enumeration System (NPPES) website. To look up your NPI information, use the NPI Registry.

References

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