What is the phone number for Wyoming Medicaid provider services?

You can 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

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.

Who is the fiscal agent for Medicaid in Wyoming?

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

How long does it take to get approved for 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.

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.

What is the largest percentage that Medicaid pays for?

Managed care and health plans accounted for the largest share (56%) of Medicaid spending, with capitated payments to comprehensive MCOs accounting for 52% of Medicaid spending in FFY 2021 and other Medicaid managed care (e.g., primary care case management (PCCM) arrangements or payments to specialty plans) accounting ...

What states have the highest Medicaid income limits?

The state with the highest income limits for both a family of three and individuals is Washington, D.C. If you live in this area, a family of three can qualify for Medicaid if their income is at 221% of the FPL. For other adults, the limit is set at 251% of the FPL.

Why hasn t Wyoming expanded Medicaid?

According to a 2023 Wyoming Department of Health Report, Medicaid expansion in the state would require $17 million to $26 million in state money and expand coverage to about 19,000 Wyomingites. Medicaid expansion efforts have repeatedly failed in the Wyoming Legislature in recent years .

Who is the director of Medicaid in Wyoming?

Dr. Paul Johnson , Wyoming Medicaid medical director with WDH, encourages patients to seek out practices recognized for offering the PCMH approach.

What is the purpose of a fiscal agent?

A fiscal agent manages fiscal matters for another entity . The fiscal agent helps with redeeming bonds or coupons, tax issues, lost or damaged securities, receiving and safeguarding funds, guaranteeing fiscal integrity, responding to audit results, maintaining accounting records, and readying financial reports.

What is the phone number for Wyoming Medicare?

1-800-MEDICARE (1-800-633-4227) Get this form in Spanish.

Does Wyoming Medicaid cover weight loss surgery?

Wyoming Medicaid covers adjustment of gastric band as medically necessary to control the rate of weight loss and/or treat symptoms secondary to gastric restriction following a laparoscopic gastric banding procedure. Does not require prior authorization.

Who is the director of the Wyoming Department of Health?

Governor Mark Gordon has appointed Stefan Johansson as director of the Wyoming Department of Health (WDH).

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 Medicaid	Claim Submission
Claim Status Inquiry	Electronic Claim Attachment
Eligibility Inquiry	LT101 Inquiry
PASRR Level I Entry and Inquiry	PA (Prior Authorization) Inquiry
RA (Remittance Advice) Listing	Upload 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 Site	Impact Address	Justification	Downtime Window
Medicaid Website	Entire Website (Provider/Member areas and all static content)	Scheduled Maintenance	1 am - 3 am MST
Provider Portal	Claims Submission Verification Unavailable	Scheduled maintenance	1 am - 3 am MST
myHealthPortal	Entire Website	Scheduled maintenance	1 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.

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.

Household Size*	Maximum Income Level (Per Year)
1	$20,030
2	$27,186
3	$34,341
4	$41,496

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

ALL COVID-19 INFORMATION HERE

FAQs

What is the phone number for Wyoming Medicaid provider services? ›

Who is the director of Medicaid in Wyoming? ›