Customer Service 

Welcome to Medicaid Customer Service.  We’re always here to to assist and provider information related to your questions.

Healthcare Portal

On-line assistance is available via access to the RI Healthcare Portal.
A Trading Partner ID will allow your office to access client eligibility and information related to claim submissions.  To obtain your TP ID, you must enroll in the Healthcare Portal.  Once your TP ID is obtained, registering that number in the Healthcare Portal will give access to the following services in the Healthcare Portal.

 

  • Eligibility Verification - including Third Party Insurance information
  • Claim Status - Paid and Denied
  • Benefit Limits - For Dental and Vision providers
  • Prior Authorization - Approvals/Denials/Pending
  • Debit Authorization - Approvals/Denials/Cancelled
  • Remittance Advice
    • Confirm payment history for the previous 12 months
    • View Remittance Advie for the previous 4 financial cycles in a PDF format
  • National Drug Code Search - Search if an NDC is reimbursable by RI Medicaid

Customer Service Help Desk

In addition to our on-line assistance, Representatives from the RI Medicaid Customer Service Help Desk (CSHD) are dedicated to answering your inquiries on the above topics or other various questions.

To expedite your calls on eligibility and claim status, please have your information readily available:
  • National Provider Identifier (NPI) 
  • Client Medicaid ID
  • Date of Service for your inquiry 

The Medicaid Customer Service Help Desk is available Monday-Friday from 8:00 AM to 5:00 PM.  The local and long-distance number is (401) 784-8100 and the in-state toll call and border community number is 1-800-964-6211.

For more complex questions and research, a Provider Representative can be contacted to arrange an on-site visit.  Provider Representatives support the following:

  • Customized training to support your programs
  • Educational workshops on billing
  • Information and guidelines on new programs
  • Training and support of the Healthcare Portal
  • Installation and training for electronic billing using Provider Electronic Solutions software

 

Links

 

 

 

 

 

PDF All PDFs require the free Adobe Reader.

 

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