Provider Training And Education

Provider Training 

 
Provider Revalidation 
Medicaid Updates 
Meet the Dental Director 

Healthcare Portal  

The Healthcare Portal is used to access business functions for RI Medicaid. Providers must enroll as a Trading Partner electronically through the Healthcare Portal. Once enrolled, Trading Partners are required to register to use the Healthcare Portal.  

User Guides and Quick Reference Guides are available on the Healthcare Portal page of this website.

Provider E-Learning Center

Welcome to the Provider E-Learning Center.  This section will be updated with new training modules as they become available.  

Self-Paced E-Learning

New Provider/New Staff Training 

Welcome New Provider  
Intended Audience:  New Medicaid providers who need information on RI Medicaid guidelines and processes.

New Office Staff Training 
Intended Audience:  New staff members or staff members assuming new roles in RI Medicaid provider offices and facilities.  It will help staff members understand the basics of conducting business with RI Medicaid.
 

Billing 

RI Medicaid provides resources for providers seeking information on billing Medicaid claims. This presentation includes the basics of billing Medicaid, Understanding Remittance Advice, and Recoupments, Adjustments, and Refunds.

Billing 101 
PES Secondary Billing
Order, Prescribe, and Refer (OPR) FAQ

Provider Specific Training

Community Health Worker Enrollment Guidance  (July 2023)

Doula Service - Provider Enrollment Guidance (June 2022)

Nursing Home Stays, 30 days or less (January 2024)

Nursing Home Slips and Billing Process Manual (March 2021)

Electronic Referrals for Home Care Agencies (January 2023)  

Nursing Home - Helpful Hints for Billing (February 2024)

Hospice Providers - Payment Methodology Changes (February 2023)

Adult Day Care Services        

Adult Day Care - Q&A    

Billing Tips for Dental Providers 

Billing Tips for Federally Qualified Health Centers 

Program Information for Home Care Providers (January 2023)
Submitting Claims through the Healthcare Portal - For Home Care Providers 

Nursing Home LTSS Application - Dos and Don'ts 

Assisted Living Services

PERM Provider Education Series

Click here for details 

Program Integrity

Click the links below for helpful resources from CMS.

CMS Toolkits - Continuing Education Podcasts
CMS Medicare Learning Network

Required Home and Community Based Services (HCBS) Provider and Direct Support Professional (DSP) Training

Pursuant to the federal Home and Community Based Services (HCBS) quality assurance requirements under 42 C.F.R. § 441.302 for all Rhode Island Medicaid HCBS providers and direct support professionals, Rhode Island is requiring annual completion of this training for anyone working directly with HCBS participants. Completion of this training annually is part of the quality measures Rhode Island reports to the Centers for Medicare and Medicaid Services (CMS) regarding the HCBS program. 

Providers and direct support professionals working with HCBS participants must register for a TRAIN account to complete the required training on an annual basis. Agencies working with HCBS participants are responsible for ensuring that each of their relevant staff members completes this required training. Please review the instructions for creating a TRAIN account, which also includes the course information, the group code to register, and contact information for assistance if needed.  

The training covers essential information related to the Final Rule, including HCBS consumer rights, person-centered care, conflict free case management (CFCM), and critical incidents. Also included is information related to the No Wrong Door (NWD) approach for long term supports and services (LTSS) and how implicit bias can impact person-centered planning. 

Please reach out to your state agency program contact OR ohhs.ltssnwd@ohhs.ri.gov with any questions. 

Click here for instructions on how to create a TRAIN account and access the training.