Welcome to the RI Medicaid Program! We are committed to helping you every step of the way. This section explains the basic standards required for billing and claims processing. If you are a new provider check out the Welcome to Medicaid - New Provider e-Learning.
Recipient Eligibility Verification: What needs to be verified and tools that can be used to verify a recipient's eligibility.
Third Party Insurance: Third party insurance codes, forms, and requirements for billing RI Medicaid.
Prior approval (PA) may be required for some services, products or procedures to verify documentation for medical necessity. Read more about Prior Authorization.
Claims: Time limits, claims payment, adjustments, and other topics of interest to providers and billers.
July 2016 - July 2017
July 2015 - July 2016
July 2014 - July 2015
July 2013 - June 2014
All PDFs require the free Adobe Reader.
74 West Road | Cranston, RI 02920 | Contact Us | Directions