Attention Providers: Change Healthcare Update Change Healthcare (CHC) can resume submitting claims to RI Medicaid. This means if you are doing business with CHC, they can submit your claims to RI Medicaid and CHC can now resume downloading your 835/277unsolicited transactions.Please reach out to your clearing house representative with any questions you may have regarding the submissions. You can also reach out to riediservices@gainwelltechnologies.com.
Recipient Eligibility Verification What Needs to be Verified A recipient's eligibility status may change periodically if financial and household circumstances change. For this reason, at each visit a provider must verify the cardholder's: Current eligiblity Program Enrollment Managed Care Other Insurance information Dental or Vision Limits (when appropriate) Correct spelling of the recipient's name Methods of Verification Healthcare Portal Providers may log into the Healthcare Portal to verify recipient eligibility. A Trading Partner ID is required to perform this function as well as registration in the Healthcare Portal. For instructions, see the Healthcare Portal Page. Batch Eligibility Verification (270/271 Transaction) The 270/271 transaction set allows trading partners to submit an eligibility request for multiple recipients at the same time. Trading partners can submit batch transactions directly to Medicaid using a vendor-created software program. Refer to the HIPAA Companion Guides for information on all HIPAA-approved transactions. Customer Service Help Desk Providers may choose to call the RI Medicaid Help Desk to verify a recipient's eligibility with a Customer Service Representative. The Medicaid Help Desk is available Monday-Friday from 8:00 AM to 5:00 PM. The local and long distance number is 401-784-8100 and the in-state toll call and border communities number is 1-800-964-6211.