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.
Long Term Care Coverage Guidelines Please note that coverage guidelines and procedures are subject to change. Refer to the monthly Provider Update for more information. Long Term Care Coverage Guidelines Claim Billing Guidelines Covered Services Limitations/Special Requirements Non-Covered Services Out of State Providers Program Information Prospective Reimbursement System Provider Participation Guidelines Recertification Reimbursement Guidelines Claim Preparation Instructions UB-04 Form Filing Instructions Long Term Care - UB-04 Claim Form Error Status Codes ESC Code List (English) Explanation of Benefits (EOB) Codes EOB Codes and Messages List (English) EOB Codes and Messages List (Spanish) Appendix - Third Party Liability Carrier and Coverage Codes Third Party Liability Carrier and Coverage Codes For specific questions you may contact the Customer Service Help Desk at (401) 784-8100 for In-state and long distance callers, or 1-800-964-6211 for In-state toll callers and border communities.