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Billing

Billing

Billing for the Application Period

Starting January 1, 2021, there is a new process to submit claims for the seven-day Application Period to Magellan.

As you submit those claims, please follow this process:

  • Download the Invoice Form
  • Complete all information highlighted
  • Enter the Service Dates
    • Date ranges should equal no more than seven days (if more than seven days, it will be returned to you).
  • Send the completed Invoice Form to WyProvider@MagellanHealth.com with the subject line "Application Invoice"

The Network Team will confirm the application date range, your mailing address and the completion of the application. Once those elements are confirmed, the invoice will be sent to the Magellan Fiscal Team. The Magellan Fiscal Team has 45 days to pay an invoice.

If you have any questions, please contact us.


Billing for all other High Fidelity Wraparound Services

The High Fidelity Wraparound billing practices involve providers direct billing Wyoming Medicaid for their services. This direct billing phase starts October 1, 2020 dates of service forward.

In preparation, Conduent has posted –

  • A recording of one of the recent trainings on the enrollment process for the Care Management Entity providers has been made available on the Wyoming Medicaid website.
  • Please contact Provider Relations at 1-800-251-1268 for any questions or further assistance.

Claim Filing Responsibilities 

The following step MUST be complete prior to submitting claims:

Need Help? Call the Interactive Voice Response (IVR) 

  • Check out the Claims Denial and Client Eligibility Troubleshooting Sheet
  •  Preparation:
    • Having a clear understanding of why you are calling will help you navigate
    • Have your WY Medicaid nine-digit provider code at the time of the call, the IVR must validate that you are an active provider prior to providing health information
    • Other important information to have prior to making your call would be:
      • Client IDs and dates of service
      • SSNs, dates of birth and dates of service
      • Transaction Control Number (TCNs) from a Remittance Advice (RA)
    • NOTE: You may complete multiple inquiries in the IVR.Having all the ID numbers and dates at the time of the call will save you time. You may remain in the IVR for up to 30 minutes before being disconnected.
  • IVR Call Center:
    • 1-800-251-1268
    • For claim status –
      • Press 1
      • Press 2 and enter your nine-digit Wyoming Medicaid ID #
      • Press 2 for information about claims status
      • Follow prompts for further information
      • To speak with an agent – Press 0 (Goes to Provider Relations Call Center)

 

Wyoming Medicaid Provider Resources

  1. Online Training
  2. Web Portal Tutorials
  3. Waiver Web Portal Tutorial
  4. Claim Edit Codes – NOTE: This is a full listing of Edit Codes and includes more than applicable to High Fidelity Wraparound
  5. Payment schedule   

 

Claims questions for services before October 1, 2020?

All claims for High Fidelity Wraparound services should be submitted within 30 days of service. Magellan will continue to work with you as a provider in resolving questions regarding claims billed to Magellan for services prior to October 1, 2020. Claims Courier, located on the Magellan Provider Portal, will remain open for claims submissions through November 30, 2020.

Claims submissions for services prior to October 1, 2020 should be completed on Magellan's provider website.

Although not the preferred method of submission, providers may send claims via a CMS-1500 form to:

Magellan Healthcare
PO Box 1498
Maryland Heights, MO 63043

 

General Claims Processing Timeline

  • Provider submits clean claim (no errors) by Tuesday 11:59 PM
  • Claim processes thru Magellan and Wyoming Medicaid
  • Payment then goes out to provider* on Tuesday of the following week.
  • Any claim denial will extend this timeline by three or more weeks.

*Provider Electronic Funds Transfer (EFT) may be same day as payment issue or following one to two business days, depending on provider’s bank.

Please consider 2020 WY Medicaid processing exceptions calendar as this could delay payments up to a full week.

Do you have question about a claim denial for services prior to October 1, 2020?

  • Please make your request –
  • Claim # and claim line only (no PHI)
  • Allow 30 days post denial before requesting research as Magellan conducts denial review proactively and may already be addressing

 

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