Attention RI Medicaid Members: Update on Prescription Access Due to a cybersecurity issue, a contractor serving pharmacies and Medicaid programs across the US is unable to provide important online services at this time. In Rhode Island, this situation impacted pharmacies’ ability to fill prescriptions for members of the AIDS Drug Assistance Program (ADAP) and the Medicaid Program. In response, RI EOHHS has quickly brought online a new way for pharmacies to process claims. Rhode Island Medicaid has also told pharmacies that they can provide a 30-day supply of any prescriptions you are trying to fill, to help you get through this time. The pharmacy should not charge you for any prescription that is covered by Medicaid. Learn more.
Provider Electronic Solutions (PES) Software Providers should be using the most current version of the PES software. New users must do a full installation of the most current version. Existing users will need to apply the upgrade that is the next consecutive version of your current software. It is recommended to download and install each upgrade as it becomes available. Full Installations PES Version 2.13 Installation Instructions Upgrades PES Upgrade Version 2.13 Installations Instructions for Upgrade 2.13 Provider Electronic Solutions Claim Guides Creating Provider and Client Lists Electronic Replacements and Voids for PES Users 837 Dental 837 Professional 837 Institutional Home Health 837 Institutional Hospice 837 Institutional Nursing Home 837 Professional Waiver 837 Institutional Outpatient 837 Institutional Inpatient Other Insurance Billing Other Insurance Billing - Dental Patient Liability for Waiver Claims View instructions on how to download the Claim Accept/Reject Report. 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.