Billing and Claims

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

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:  Third party insurance codes, forms, and requirements for billing RI Medicaid.

Prior Authorization

Prior approval (PA) may be required for some services, products or procedures to verify documentation for medical necessity.  Read more about Prior Authorization.

Submitting Claims to Medical Assistance

Claims:  Time limits, claims payment, adjustments, and other topics of interest to providers and billers.

Payment and Processing Schedule

July 2014 - July 2015  
July 2013 - June 2014 


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