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MedicAide October 2020 Page 1 of 37
In This Issue Certification Requirements for Fitted and Customized Orthotics ..................................................... 2 Hospital Observation Services .................................................................................................... 2 Drug Testing Laboratory and Pathology Policy.............................................................................. 4 Provider Enrollment Application Upgrade, System Unavailability and Training Opportunities .............. 4 Changes to Contacting Your Provider Relation Consultant .............................................................. 5 Finalized Limitations on DMEPOS ............................................................................................... 5 Finalized Limitations on Hearing Aid and Cochlear Implant Batteries ............................................... 7 Notice of Idaho Medicaid Section 1115 Behavioral Health Transformation Demonstration Waiver ....... 7 Post-Award Public Forum .......................................................................................................... 7 CPT® and HCPCS Coverage Update ............................................................................................ 8 Provider Training Opportunities in 2020 .....................................................................................32 Medical Care Unit Contact and Prior Authorization Information ......................................................33 DHW Resource and Contact Information ....................................................................................34 Insurance Verification ..............................................................................................................34 DXC Technology Provider and Participant Services Contact Information .........................................35 DXC Technology Provider Services Fax Numbers .........................................................................35 Provider Relations Consultant (PRC) Information .........................................................................36
Information Releases MA20-30 - COVID-19 Laboratory and Pathology Services - UPDATED .................................................... 10 MA20-39 - Medical Waste of Drugs and Biologicals .............................................................................. 15 MA20-41 - Returning to School and Requesting CHIS Increases ............................................................ 20 MA20-43 - Drug Testing Policy .......................................................................................................... 23
An Informational Newsletter for Idaho Medicaid Providers
From the Idaho Department of Health and Welfare, October 2020
Division of Medicaid
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Certification Requirements for Fitted and Customized Orthotics
The Medicaid Program Integrity Unit has identified providers billing for customized and/or fitted orthotics without proper certification. Idaho Medicaid requires all providers who supply clients with fitted and/or customized orthotics to be certified by the American Board for Certification in orthotics and/or prosthetics. This also applies to employees and contracted staff who are directly furnishing such orthotics to clients. Orthotics customized and/or fitted by uncertified individuals are not reimbursable by Medicaid. IDAPA 16.03.09.772.01 describes the coverage and limitations for prosthetic and orthotic services. It states, in pertinent part:
01. Program Requirements. The following program requirements will be applicable for all prosthetic and orthotic devices or services purchased by the Department: c. All prosthetic and orthotic devices that require fitting must be provided by an individual who is certified or registered by the American Board for Certification in Orthotics and/or Prosthetics; or both;
The Healthcare Common Procedure Coding System’s (HCPCS) code descriptors can be used as a tool when determining if an orthotic device is considered fitted or customized. For example, HCPCS code L1843 has a descriptor that states: Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise. While this orthotic may be defined as “prefabricated”, the descriptor also states that it needs to be “otherwise customized”. Supplying a client with an L1843 knee orthosis would require the individual to be certified by the American Board for Certification. Customized and/or fitted orthotic and prosthetic devices supplied to Medicaid clients by an individual without the proper certification will be subject to recoupment and civil monetary penalties.
Hospital Observation Services Observation services are furnished on hospital premises and include the use of a hospital bed and periodic monitoring by hospital nursing staff. Services must be ordered by a physician or non-physician practitioner. Observation is used by the treating physician or non-physician practitioner for a short period of time to assess and decide whether a participant requires admission for inpatient care or should be discharged. Idaho Medicaid covers observation services for up to 48 hours. Observation services exceeding 48 hours require a prior authorization from the Medical Care Unit. Observation services are not covered for:
• Holding a participant while waiting for an appropriate place for discharge. • An emergency department/room visit, or related nursing services rendered outside the
emergency department/room. • Failure to request inpatient days from the QIO or denied stays when the intensity of
services does not justify an inpatient day. • The convenience of the participant, their family, or the physician. • The consequences of a procedure or treatment provided erroneously to the participant.
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• General standing orders for observation services following all outpatient surgery. Standard recovery time after surgery should be billed as recovery room services, not observation services. Observation services are not billable for routine preparation and recovery for diagnostic procedures. These services are reimbursed in the payment for the procedure. The medical record must include documentation such as an order, outpatient registration, discharge, and other appropriate progress notes that are timed, written, and signed by the physician or non-physician practitioner. It must explicitly document that the physician or non-physician practitioner assessed the participant’s risk and determined they would benefit from observation. Observation should be billed under the revenue code that reflects the service area in which the provider accounts for the participant and the related costs (i.e., if services are provided in the emergency room, they should be billed under revenue code 0450.). Revenue code 0760 or 0762 with bill type 13X or 85X should be used to reflect the costs of routine observation services provided in an inpatient bed. Ancillary revenue codes should be used for other services provided. Effective December 1, 2020, claim lines for observation care should be billed with one date of service per line. Revenue codes for must include one of the following HCPCS:
• G0378: Hospital observation service, per hour. This HCPCS is used for admission after receiving another hospital service such as being seen in the emergency room, clinic, or surgical procedure.
• G0379: Direct admission of patient for hospital observation care. This HCPCS is used for admission to observation from the community.
Observation time for billable units begins at the time documented in the participant’s medical record and should correspond with the physician or non-physician practitioner’s order. Units should be counted by rounding to the nearest hour. Billable observation time ends when all medically necessary services related to the observation service ends. Other medically necessary services can be provided and billed separately after observation services are over. Time spent providing followup care after the physician orders discharge is counted, but waiting the participant waiting for transport would not. Observation services are not covered while the participant receives diagnostic or therapeutic services. A therapeutic or diagnostic procedure that includes active monitoring time as part of the procedure that interrupts observation time must be deducted from the total observation time. Hospitals must determine a policy for whether they will deduct the average time the procedure takes for their facility or the actual amount of time of each participant’s procedure. Medicaid does not support the 72-hour Medicare rule for combining inpatient and outpatient services. When observation results in a direct admit to inpatient status, claims should be split for the observation and inpatient services with the observation being billed separately on an outpatient bill type. The inpatient claim’s field for the “from date of service” must be the admit date. Observation services provided on the same date of service as an inpatient day are bundled into the payment for the inpatient reimbursement. Questions and comments about this article should be submitted to the Medical Care Policy Team at [email protected].
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Drug Testing Laboratory and Pathology Policy The limitations on the quantity of tests allowed established in the Drug Testing Laboratory and Pathology Coverage articles in the 2020 March and April editions of the MedicAide newsletter will not be audited against or enforced. However, providers will still be audited against other aspects of the newsletter articles, previous MedicAide newsletters, and the clinical guidelines, frequency, limitations and documentation requirements in Local Coverage Determination (LCD): Lab: Controlled Substance Monitoring and Drugs of Abuse Testing (L36707) from CMS and the Idaho regional Medicare contractor, Noridian. Please, allow additional time for the system to be updated. Claims will be reprocessed once complete. Providers are responsible for insuring the claims they submitted and the services they represent meet all requirements. A paid claim is not an acknowledgement by the Department of a service being appropriate. A finalized policy effective October 1, 2020 will be published as Information Release MA20-43 Drug Testing Policy. Questions and comments about this article may be submitted to the Medical Care Policy Team at [email protected].
Provider Enrollment Application Upgrade, System Unavailability and Training Opportunities
In preparation for the much-anticipated Provider Enrollment Application upgrade, the existing Idaho Medicaid Provider Enrollment Application (PEA) and system will be unavailable from 10/24/2020 through 11/08/2020 for the implementation of the upgraded product and system. The following points should be closely reviewed to ensure preparation and understanding:
• Providers are encouraged to submit necessary maintenance before 10/24/2020 for processing.
• All new enrollment and electronic maintenance requests will not be allowed between 10/24/2020 through 11/08/2020.
• All paper maintenance requests will be returned as the system will be inaccessible during this period and paper maintenance will be eliminated in the upgraded system.
• Any new enrollment or maintenance requests that are unable to be submitted or processed during this time will be considered for approval of a backdated effective date.
• If needed, providers can contact their Provider Relations Consultant for support with submitting maintenance in the upgraded PEA system after implementation.
The upgraded Idaho Medicaid Provider Enrollment Application will feature a new look and feel, simplified processes for new enrollments and maintenance requests and feature dynamic screens and electronic signature options, which will result in quicker processing times and eliminate paper transactions. Please start preparing for these upcoming changes by attending the upcoming training sessions. All upcoming training dates and times, along with topics and registration information can be found on the Training Calendar. Thank you for your patience during this time, we look forward to sharing this upgrade with you!
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Changes to Contacting Your Provider Relation Consultant Effective immediately, the Provider Relation Consultants (PRCs) are only able to be contacted via email and no longer have access to the contact telephone numbers you may have reached them at before. Please see the updated PRC contact email addresses in the table below. If you're unable to send an email to your PRC, please contact the DXC Technology Call Center at 1(866)686-4272 and ask to have a message delivered to your Regional PRC who will contact you directly, the same or next business day. Region 1 and the state of Washington [email protected] Region 2 and the state of Montana [email protected] Region 3 and the state or Oregon [email protected] Region 4 and all other states [email protected] Region 5 and the state of Nevada [email protected] Region 6 and the state of Utah [email protected] Region 7 and the state of Wyoming [email protected]
Thank you for your cooperation and understanding!
Finalized Limitations on DMEPOS Idaho Medicaid solicited comments in August and September from providers on changes to proposed shared limitations for durable medical equipment and supplies. No comments were received, and changes were implemented as proposed. Implemented changes will be reviewed periodically for billing trends and reassessment. All codes with a shared limit must have the same limitation for the claims processing system to bundle the codes together. Because two items don’t share a limit, doesn’t mean it’s appropriate to supply those items together. The descriptions presented here are for the general purpose of reading this article. The official code descriptions still apply.
Description Codes Shared Limit Effective Date
Syringe with needle, sterile, 1 cc or less
A4206 100 per month 10/01/2020
Syringe with needle, sterile 2cc
A4207 100 per month 10/01/2020
Syringe with needle, sterile 3cc
A4208 100 per month 10/01/2020
Syringe with needle, sterile 5cc or greater
A4209 100 per month 10/01/2020
Syringe, sterile, 20 cc or greater
A4213 30 per month 10/01/2020
Needle, sterile, any size A4215 100 per month 10/01/2020 Blood glucose monitor batteries
A4233, A4234, A4235, A4236
1 per 3 months 10/01/2020
Alcohol or peroxide, per pint
A4244 2 per month 10/01/2020
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Description Codes Shared Limit Effective Date
Normal, low and high calibrator solution/chips
A4256 1 per month 10/01/2020
Syringe with needle for external insulin pump
A4232 15 per month 10/01/2020
Disposable drug delivery system
A4305, A4306 36 per 3 months 10/01/2020
Ostomy skin barrier 1 A4373, A4385, A4407, A4408, A4409, A4410
20 per month 10/01/2020
Ostomy faceplate equivalent, silicone ring
A4384 10 per month 10/01/2020
Ostomy pouch 1 A4387 60 per month 10/01/2020
Ostomy pouch 2
A4375, A4376, A4378, A4379, A4380 A4382, A4383, A4388, A4389, A4390, A4391, A4392, A4393, A4412, A4413, A4428, A4430, A4435
10 per month 10/01/2020
Ventilator moisture exchanger, disposable A4483 30 per month 10/01/2020
Surgical stockings A4490, A4495, A4500,
A4510
4 per left or right limb in six
months 10/01/2020
Conductive gel or paste for electrical device A4558 32oz per month 10/01/2020
Slings A4565 2 per year 10/01/2020 Battery for Infusion Pumps A4602 1 per 2 years 10/01/2020 Tracheal suction catheter A4605 12 per month 10/01/2020 Peritoneal dialysis catheter anchoring device A4653 1 per month 10/01/2020
Dialysate solution for peritoneal dialysis A4728 250 per month 10/01/2020
Non-sterile gloves, per 100 A4927 4 per month 10/01/2020 Gloves, sterile, per pair A4930 45 per month 10/01/2020 Bandages A6453, A6454, A6455 60 per month 10/01/2020
Gradient compression stocking
A6530, A6531, A6532, A6533, A6534, A6535,
A6545, A6549
1 per left or right limb per 6
months 10/01/2020
Gradient compression stocking 2
A6536, A6537, A6538, A6539, A6540, A6541,
A6544 1 per 6 months 10/01/2020
Questions and comments about this article should be submitted to the Medical Care Policy Team at [email protected].
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Finalized Limitations on Hearing Aid and Cochlear Implant Batteries
Idaho Medicaid solicited comments in August and September from providers on changes to limitations for hearing aid and cochlear implant batteries. No comments were received, and changes were implemented as proposed. Implemented changes will be reviewed periodically for billing trends and reassessment. All codes with a shared limit must have the same limitation for the claims processing system to bundle the codes together. Because two items don’t share a limit, doesn’t mean it’s appropriate to supply those items together. The descriptions presented here are for the general purpose of reading this article. The official code descriptions still apply. The claims processing system is unable to determine if a participant has a single hearing aid or binaural hearing aids. Providers supplying batteries for a participant with a single hearing aid are responsible for ensuring they don’t dispense over the allowed 8 batteries.
Description Codes Shared Limit Effective Date
Cochlear Implant Batteries
L8621, L8622 36 per 30-days 10/01/2020
Hearing Aid Batteries V5266
8 per month for single hearing aids (per policy).
16 per month for binaural (per
system).
10/01/2020
Questions and comments about this article should be submitted to the Medical Care Policy Team at [email protected].
Notice of Idaho Medicaid Section 1115 Behavioral Health Transformation Demonstration Waiver
Post-Award Public Forum Effective April 17, 2020, the Centers for Medicare and Medicaid Services (CMS) approved Idaho Medicaid’s §1115 Behavioral Health Transformation Demonstration Waiver for a five-year period. In addition to enabling reimbursement of services delivered in Institutions for Mental Diseases (IMDs), the waiver is expected to enhance the entire behavioral health continuum of care by expanding the depth and breadth of the overall array of behavioral health services available through state- and federal-funded programs. In addition, this waiver is intended to help decrease reliance on the most intensive and costly levels of care, such as crisis services, acute psychiatric hospitalizations, and residential treatment. Pursuant to 42 CFR 431.420(c), Idaho Medicaid must conduct a post-award forum within six (6) months of the approval date for the demonstration. Although six months from the approval date falls on October 17, 2020, Idaho requested and received an extension from CMS so that the forum could be held at the October 21 public meeting of the Medical Care Advisory Committee (MCAC).
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The forum is intended to provide the public with the opportunity to offer meaningful comment on the progress of the demonstration. Details on the forum appear below. Public comments will be accepted through end of day Monday, November 2, 2020. Please send written comments by email to [email protected] or by regular postal mail to Division of Medicaid Policy Unit, P.O. Box 83720, Boise, ID 83720-0009. Post-Award Forum Information Event: Public Meeting of the Medical Care Advisory Committee (MCAC) Date: Wednesday, October 21, 2020 Time: 3:30-4:30 PM Location: N/A—conducted virtually via Webex Call-in Number: 1-415-655-0003 Meeting Number: 133 093 7548 Password: 10212020 Link: https://idhw.webex.com/idhw/j.php?MTID=m60885e206fd1a557443cdb6b69927c64 This public forum will be made accessible to persons with disabilities. Written requests for accommodation must be received at this address—Medicaid Policy Unit, P.O. Box 83720, Boise, ID 83720-0009—not later than October 7, 2020, which is ten (10) working days prior to the forum. Links to Reference Documents CMS Approval Letter: https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/id-behavioral-health-transformation-ca.pdf §1115 Final Waiver Application: https://medicaidexpansion.idaho.gov/Portals/118/Assets/Documents/Idaho1115BH_IMD_WaiverPkgRD.pdf
CPT® and HCPCS Coverage Update The following codes are being added for coverage. Please, allow additional time for the system to be updated. Claims will be reprocessed once complete. All statute, rule and provider handbook requirements apply. In the event that the system is configured before pricing is available from Medicare, the pricing will be implemented retroactively and claims reprocessed.
Covered Codes Codes Description Effective
Date Prior
Authorization 86413 Severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative
9/8/2020 No
87426 Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome
7/1/2020 No
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coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])
C9060 Fluoroestradiol f18, diagnostic, 1 mci 10/1/2020 N/A C9062 Injection, daratumumab 10 mg and hyaluronidase-
fihj 10/1/2020 Pharmacy
C9064 Mitomycin pyelocalyceal instillation, 1 mg 10/1/2020 Pharmacy C9065 Injection, romidepsin, non-lypohilized (e.g. liquid),
1mg 10/1/2020 N/A
C9066 Injection, sacituzumab govitecan-hziy, 10 mg 10/1/2020 Pharmacy C9067 Gallium ga-68, dotatoc, diagnostic, 0.01 mci 10/1/2020 N/A C9761 Cystourethroscopy, with ureteroscopy and/or
pyeloscopy, with lithotripsy (ureteral catheterization is included) and vacuum aspiration of the kidney, collecting system and urethra if applicable
10/1/2020 N/A
C9768 Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (list separately in addition to code for primary procedure)
10/1/2020 N/A
C9769 Cystourethroscopy, with insertion of temporary prostatic implant/stent with fixation/anchor and incisional struts
10/1/2020 N/A
J1437 Injection, ferric derisomaltose, 10 mg 10/1/2020 N/A J1632 Injection, brexanolone, 1 mg 10/1/2020 Pharmacy J1738 Injection, meloxicam, 1 mg 10/1/2020 N/A J3032 Injection, eptinezumab-jjmr, 1 mg 10/1/2020 Pharmacy J3241 Injection, teprotumumab-trbw, 10 mg 10/1/2020 Pharmacy J7351 Injection, bimatoprost, intracameral implant,N 1
microgram 10/1/2020 Pharmacy
J9227 Injection, isatuximab-irfc, 10 mg 10/1/2020 Pharmacy J9304 Injection, pemetrexed (pemfexy), 10 mg 10/1/2020 N/A
CPT codes, descriptions and other data only are copyright 1995 - 2017 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA). Questions about this article may be submitted to the Medical Care Policy Team at [email protected].
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Figure 1MA20-30 - COVID-19 Laboratory and Pathology Services - UPDATED
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Figure 2MA2039 Medical Waste of Drugs and Biologicals
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Figure 3MA20-41 - Returning to School and Requesting CHIS Increases
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Figure 4 MA20-43 - Drug Testing Policy
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Provider Training Opportunities in 2020 You are invited to attend the following webinars offered by DXC Technology Regional Provider Relations Consultants.
October: Pre-Go Live Provider Enrollment Application Presentation This training will demonstrate the upgraded Provider Enrollment Application system in preparation for go-live. The upgraded Idaho Medicaid Provider Enrollment Application will feature a new look and feel, simplified processes for new enrollments and maintenance requests and feature dynamic screens and electronic signature options, which will result in quicker processing times and less paper transactions. Join us to see some of these upgraded features! Training is delivered at the times shown in the table below. Each session is open to any region, but space is limited to 25 participants per session, so please choose the session that works best with your schedule. To register for training, or to learn how to register, visit www.idmedicaid.com. October November December
Pre-Go Live PEA
Presentation
PEA Presentation PEA Presentation
10-11:00 AM MT
10/15/2020 11/17/2020 Maintenance 12/15/2020 Maintenance 10/20/2020 11/18/2020 ORP & Convert
to Full 12/16/2020 New Enrollment
10/21/2020 11/19/2020 Maintenance 12/17/2020 Maintenance
2-3:00 PM MT
10/14/2020 11/11/2020 Maintenance 12/09/2020 Maintenance 10/15/2020 11/12/2020 New Enrollment 12/10/2020 New Enrollment 10/20/2020 11/17/2020 Disenrollment &
Reactiviation 12/15/2020 Disenrollment &
Reactiviation 10/29/2020 11/19/2020 New Enrollment 12/17/2020 ORP & Convert
to Full If you would prefer one-on-one training in your office with your Regional Provider Relations Consultant, please feel free to contact them directly. Provider Relations Consultant contact information can be found on page 36 of this newsletter.
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Medical Care Unit Contact and Prior Authorization Information
Prior Authorizations, Forms, and References To learn about prior authorization (PA) requirements or quality improvement organization (QIO) review, or to print request forms, go to the Medical Care tab on the IDHW Division of Medicaid webpage. Prior authorization request forms containing the “fax to” number can be found at www.idmedicaid.com. Select Forms under the References section and you will see the PA request forms under the DHW Forms heading. If you prefer to mail in your form, the mailing address is:
Medicaid Medical Care Unit P.O. Box 83720 Boise, ID 83720-0009
Note: The Medical Care Unit (MCU) does not give authorizations for services over the telephone or for services which do not require a PA. The MCU is currently handling a very high volume of PA requests; turnaround is therefore slower than usual and PAs may take up to 30 days to be reviewed. To Check Prior Authorizations Status Log on to your Trading Partner Account on www.idmedicaid.com. Choose Form Entry, then choose View Authorizations. If you are unable to identify the reason for a denied service, a DXC Technology representative can provide the medical reviewer’s reason captured in the participant’s non-clinical notes. If you are unable to view the authorization status, please review the Trading Partner Account (TPA) User Guide located under User Guides at www.idmedicaid.com. To speak to a DXC Technology representative, call 1 (866) 686-4272, Option 3. MCU Medical Review Decisions If you have any questions about medical review decisions, please refer to the contact numbers below or e-mail [email protected].
For the Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) PA Policy and Medical Criteria, please go to the Resources tab on the Durable Medical Equipment page. Please review the DMEPOS PA Policy and Medical Criteria to obtain important information, policy, and guidance related to requesting PAs for DMEPOS items. This document also includes the medical criteria used by the department in most circumstances related to DMEPOS requests.
Fax Number Phone Number Administratively Necessary Days 1 (877) 314-8779 1 (866) 205-7403 Ambulance* 1 (877) 314-8781 1 (800) 362-7648 Breast & Cervical Cancer 1 (877) 314-8779 1 (866) 205-7403 Durable Medical Equipment 1 (877) 314-8782 1 (866) 205-7403 Hospice 1 (877) 314-8779 1 (866) 205-7403 Preventive Health Assistance 1 (877) 845-3956 1 (866) 205-7403 Service Coordination 1 (877) 314-8779 1 (866) 205-7403 Surgery-Procedure-Lab 1 (877) 314-8779 1 (866) 205-7403 Therapy: OT, PT, SLP 1 (877) 314-8779 1 (866) 205-7403 Vision 1 (877) 314-8779 1 (866) 205-7403
*Idaho Medicaid contracts with Medical Transportation Management (MTM) for all non-emergency medical transportation (NEMT) services. Please go to http://www.mtm-inc.net/idaho/ or call 1 (877) 503-1261 for more information.
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DHW Resource and Contact Information DHW Website https://healthandwelfare.idaho.gov/
Idaho CareLine 2-1-1 1 (800) 926-2588
Medicaid Program Integrity Unit P.O. Box 83720 Boise, ID 83720-0036 [email protected] Fax: 1 (208) 334-2026
Telligen 1 (866) 538-9510 Fax: 1 (866) 539-0365 http://IDMedicaid.Telligen.com
Healthy Connections Regional Health Resource Coordinators Region I Coeur d'Alene
1 (208) 666-6766 1 (800) 299-6766
Region II Lewiston
1 (208) 799-5088 1 (800) 799-5088
Region III Caldwell
1 (208) 455-7244 1 (208) 642-7006 1 (800) 494-4133
Region IV Boise
1 (208) 334-0717 1 (208) 334-0718 1 (800) 354-2574
Region V Twin Falls
1 (208) 736-4793 1 (800) 897-4929
Region VI Pocatello
1 (208) 235-2927 1 (800) 284-7857
Region VII Idaho Falls
1 (208) 528-5786 1 (800) 919-9945
In Spanish (en Español)
1 (800) 378-3385
Insurance Verification HMS PO Box 2894 Boise, ID 83701
1 (800) 873-5875 1 (208) 375-1132 Fax: 1 (208) 375-1134
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DXC Technology Provider and Participant Services Contact Information
Provider Services MACS (Medicaid Automated Customer Service)
1 (866) 686-4272 1 (208) 373-1424
Provider Service Representatives Monday through Friday, 7 a.m. to 7 p.m. MT
1 (866) 686-4272 1 (208) 373-1424
E-mail [email protected] [email protected]
Mail P.O. Box 70082 Boise, ID 83707
Participant Services MACS (Medicaid Automated Customer Service)
1 (866) 686-4752 1 (208) 373-1432
Participant Service Representatives Monday through Friday, 7 a.m. to 7 p.m. MT
1 (866) 686-4752 1 (208) 373-1424
E-mail [email protected]
Mail – Participant Correspondence P.O. Box 70081 Boise, ID 83707
Medicaid Claims
Utilization Management/Case Management P.O. Box 70084 Boise, ID 83707
CMS 1500 Professional P.O. Box 70084 Boise, ID 83707
UB-04 Institutional P.O. Box 70084 Boise, ID 83707
UB-04 Institutional Crossover/CMS 1500/Third-Party Recovery (TPR)
P.O. Box 70084 Boise, ID 83707
Financial/ADA 2006 Dental P.O. Box 70087 Boise, ID 83707
DXC Technology Provider Services Fax Numbers Provider Enrollment 1 (877) 517-2041 Provider and Participant Services 1 (877) 661-0974
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Provider Relations Consultant (PRC) Information
Region 1 and the state of Washington [email protected]
Region 2 and the state of Montana [email protected]
Region 3 and the state of Oregon [email protected]
Region 4 and all other states [email protected]
Region 5 and the state of Nevada [email protected]
Region 6 and the state of Utah [email protected]
Region 7 and the state of Wyoming [email protected]
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Digital Edition MedicAide is available online by the fifth of each month at www.idmedicaid.com. There may be occasional exceptions to the availability date as a result of special circumstances. The electronic edition reduces costs and provides links to important forms and websites. To request a paper copy, please call 1 (866) 686-4272.
DXC Technology PO Box 70082 Boise, Idaho 83707
MedicAide is the monthly informational newsletter for Idaho Medicaid providers. Editor: Shannon Tolman
If you have any comments or suggestions,
please send them to: Shannon Tolman,
[email protected] Medicaid – Communications Team
P.O. Box 83720 Boise, ID 83720-0009 Fax: 1 (208) 364-1811