MCO Contract Update RI EOHHS and Medicaid are in the process of establishing a new managed care contract. If you or a loved one currently have health coverage through RI Medicaid, it’s important to know that you don’t need to take any action at this time. When a new contract is in place, the State will send information about any next steps.
Healthcare Portal Providers must use the Healthcare Portal for access to information, including eligibility verification, remittance advice, prior authorization, claim status. Providers must enroll as a Trading Partner and then register to use the Healthcare Portal. To go directly to the Healthcare Portal, click here. Electronic Data Interchange (EDI) questions can be directed to: Phone: (401) 784-8100 for local and long distance calls or (800) 964-6211 for in-state toll calls Email: RI EDI Services For Healthcare Portal password resets, be sure to include your NPI and Trading Partner ID. New Trading Partners Enrollment as a new Trading Partner is completed electronically through the Healthcare Portal. No paper documents needed. For enrollment instructions, see the user guide on the bottom of this page. New Providers must enroll to become a Trading Partner on the Healthcare Portal. Existing Trading Partners Existing Trading Partners are required to register in the Healthcare Portal. All providers, clearinghouses, and billing entities must register to have access to information needed to conduct business. Existing Trading Partners/Users must register now on the new Healthcare Portal. Self-Paced User Guides The following User Guides will walk you through the process of enrolling as a new Trading Partner, registering to use the Healthcare Portal, and using the Healthcare Portal to conduct business. Enrolling as a New Trading Partner Registering to Use the Healthcare Portal Using the Healthcare Portal Managing Covered Providers Guide Quick Reference Guides These guides answer frequently asked questions and offer tips to providers on using the Healthcare Portal. Quick Reference Guide - Mass Immunizer Roster Billing Quick Reference Guide - Password Help Quick Reference Guide - Registration Tips Quick Reference Guide - Access to Web Services Quick Reference Guide - 835.277U Transactions Quick Reference Guide - Verifying Eligibility Quick Reference Guide - Claims Search Quick Reference Guide - Remittance Advice