Wyoming

  Medicaid

 

Home

 

Provider Welcome

 

Provider Portal

 

Provider Manuals and Bulletins

 

Provider Enrollment

 

  Provider Web
          Registration
 
Provider Locator

 

Enroll/Re-enrollment Information

 

Browsers

 

Contact Us

 

Dental

FAQs

 

Fee Schedules Fee Schedules

 

Forms

 

HIPAA

HIPAA 5010

ICD10

 
Interpretation Services  COVID-19 Information

 

Links

 

Medicare Part D

 

NDC Billing Requirement

 

OPPS OPPS Information

 

Training Provider Training
 
Service Content Removed

 

Vendor Services

 

Web Tutorials

 

WINASAP

 

What's New

Serving Wyoming Medicaid Providers

 

 

Links to Related Sites

General Information

HHS Link
CNSI Link
CMS Medicaid Program Integrity Education
EDI Solutions
American Academy of Pediatrics - Immunization Initiatives
Centers for Medicare & Medicaid Services (CMS) [formerly HCFA]
Clinical Laboratory Improvement Amendments (CLIA)
Change Healthcare PBM Vendor
Medicaid Recovery Audit Contract (RAC)
Division of Healthcare Financing
State of Wyoming Government
Wyoming Psychological Association
Wyoming State Auditor's Office

Change Healthcare (CHC) - Change Healthcare is contracted by the Department of Health, Division of Healthcare Financing, Medicaid program to provide services to over 55,000 Medicaid clients.  Services provided by CHC include:

  • Claims processing for pharmacy services
  • Prescriptions
  • Injectable Drugs (J-Codes)
  • Infusion Drugs (J-Codes)

Client Network Services, Inc. (CNSI) - CNSI is the new vendor contracted by the Department of Health Division of Healthcare Financing, Medicaid program to provide services to over 55,000 Medicaid clients and providers.  CNSI will begin providing the following services on October 25, 2021:

  • Claims Processing
    • Claim adjustment submissions
    • Hardcopy claims submissions
    • Returning Medicaid Checks
  • Dental Services
    • Bulletin/Manual inquires
    • Claims inquiries
    • Claim submission problems
    • Client eligibility
    • How to complete forms
    • Payment inquiries
    • Request Field Representative visit
    • Training seminar questions
    • Timely filing inquiries
    • Verifying  validity of procedure codes
    • Claim void/adjustment inquires
  • EDI Services
    • EDI Enrollment Forms
    • Trading Partner Agreement
    • Technical support for vendors, billing agents, and clearing houses
    • Web Portal registration/password reset
    • Technical support for Web Portal
  • Provider Relations
    • Bulletin/Manuals inquiries
    • Claim inquiries
    • Claim submission problems
    • Claim eligibility
    • Claim void/adjustment inquires
    • Form completion
    • Payment inquiries
    • Request Field Representative visit
    • Training seminar questions
    • Timely Filing inquiries
    • Verifying validity of procedure codes
  • Third Party Liability
    • Client accident by liability or casualty insurance or legal liability is being pursued
    • Estate Trust Recovery
    • Medicare Buy-In status
    • Reporting client TPL
    • New insurance coverage
    • Policy no longer active
    • Problems getting insurance information needed to bill
    • Questions or problems regarding third party coverage or payers
    • WHIPP program
  • Transportation Services
    • Client inquiries
      • Prior authorize transportation arrangement
      • Request travel assistance
      • Verify transportation is reimbursable
  • Provider Manuals
  • HIPAA electronic transaction data exchange
  • Fee schedules
  • Frequently asked questions (FAQs)
  • Forms (e.g. Claim Adjustment/Void Request Form)
  • Contacts
  • What' New
  • Remittance Advice Retrieval
  • EDI enrollment form
  • Trading Partner Agreement
  • Secured Provider Portal
  • Training Tutorials

Wyoming Cancer Program (WCP) - Access this website for detailed provider information, including covered Diagnosis (DX) Codes and CPT Codes, for the Breast & Cervical Cancer (BCC) and Colorectal Cancer (COLR) Screening Programs.


WYhealth (Optum) - WYhealth is contracted by the Department of Health, Division of Healthcare Financing, Medicaid program to provide services to over 55,000 Medicaid clients. Services provided by Optum  include:

  • Total Population Health Management services for all Medicaid Clients
  • Utilization Management (UM) services for select medical and behavioral health admissions and procedures that require authorization:
    • Acute Psych
    • Extended Psych
    • Extraordinary heavy care
    • Gastric Bypass
    • Psychiatric Residential Treatment
    • Facility (PRTF)
    • Transplants
    • Vagus Nerve Stimulator
    • Unlisted Procedure Codes with dates of service on or after 2/1/20
    • Surgeries that require authorization with dates of service on or after 2/1/20
    • Vision services that require authorization with dates of service on or after 2/1/20.
     

External Linking Policy

This page contains external links that are not the responsibility of, or under the control of the Wyoming Medicaid Program. Wyoming Medicaid does not endorse any commercial products, services or web sites. The Wyoming Medicaid Program may not be held liable for the informational content or services provided on any external web sites which link from the Wyoming Medicaid web site.