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.
Trading Partner Enrollment Trading Partner Information Any business entity who will exchange electronic data with the Rhode Island Medicaid Program and/or uses our Healthcare Portal, will be required to enroll as a Trading Partner with the Executive Office of Health and Human Services (EOHHS) and its fiscal agent, Gainwell Technologies. The Healthcare Portal can be used to: upload claims, download remittances, provide interactive eligibility verification, check claims status and prior authorization inquiry, look-up NDC, use the message center, and get remittance payment verification. Each billing provider, clearinghouse, or billing service who will directly exchange electronic data with Gainwell Technologies must enroll as a Trading Partner. The Trading Partner must register all RI Medicaid providers, for whom the Trading Partner submits electronic claim(s), or accesses electronic remittance advice(s), checks claim status and/or checks eligibility status. To complete the online Trading Partner Agreement, visit the Healthcare Portal. For additional information, visit the Healthcare Portal Resource page. For instructions on how to manage your covered provider's ERA enrollment for the new automated 835/277U transactions and for adding covered providers to your Trading Partner Profile please go tot he link below. Managing Covered Providers Guide