Wyoming

  Medicaid

Serving Wyoming Medicaid Providers and Clients

 

 



Benefit Management System and Services (BMS) Vendor Transition

The Benefits Management System and Services (BMS) for Wyoming Medicaid will transition to a new fiscal agent, CNSI. The new Wyoming Medicaid website has launched at: wyomingmedicaid.com

Other service vendor websites are below.
Provider
Enrollment
HHS Technology Group:
https://wyoming.dyp.cloud/landing

 

Utilization Review
WYhealth (Optum): https://www.wyhealth.net/tpa-ap-web/?page=defaultRoot
Optum is the vendor responsible for medical Prior Authorizations, Threshold Authorizations, and Utilization Review of services billed to Wyoming Medicaid.

 

Pharmacy
Change Healthcare: http://www.wymedicaid.org/
Change Healthcare is the vendor responsible for pharmacy claims and Prior Authorizations.

 

Client
Member Inquires
For all inquiries call the Client Service Center (CSC) between the hours of 7AM – 6PM MST Monday-Friday at:
(855) 294-2127
TTY/TDD (855) 329-5205

 

State Agency Responsibilities
PThe Division of Healthcare Financing administers the Medicaid Program for the Department of Health. They are responsible for financial management, developing policy, establishing benefit limitations, payment methodologies and fees, and performing utilization review.

 

Fiscal Agent Responsibilities
CNSI is the fiscal agent for Wyoming Medicaid. They process all claims and adjustments. They also answer provider inquiries regarding claim status, payments, client eligibility and known third party insurance information. They provide on-site visits to train and assist your office staff on Wyoming Medicaid billing procedures or to resolve claims payment issues.