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Medicaid Managed Care Medicare commercial

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Frequently Asked Questions

Please reach us at  if you cannot find an answer to your question.

Below are each State Medicaid that we can process. Click each link to visit the provider portal page.


Alabama: Home   (alabamaservices.org)   

Alaska: Alaska   Medical Assistance Health Enterprise Portal (medicaidalaska.com)   

Arizona: https://ao.azahcccs.gov/Account/Login.aspx?ReturnUrl=%2f

Arkansas: Arkansas   Provider Portal > Home   

California:  PAVE Provider Portal (ca.gov)   

Colorado: Colorado   Provider Portal > Home (gainwelltechnologies.com)   

Connecticut: Provider (ctdssmap.com)   

Delaware: Delaware   Medical Assistance Portal for Providers > Home   

Florida:  Enrollment   Status | Florida Medicaid Web Portal (flmmis.com)   

Georgia: Home (georgia.gov)   

Hawaii: Log In   (statemedicaid.us)   

Idaho: Sign   In (idmedicaid.com)   

Iowa:  Provider Enrollment | Health & Human Services (iowa.gov) 

Illinois:  www2.illinois.gov/hfs/impact/Pages/default.aspx   

Indiana: IHCP   Provider Portal > Home (indianamedicaid.com)   

Kansas: New   Enrollment (kmap-state-ks.us)   

Kentucky: HCP   Provider Portal > Home (indianamedicaid.com)   

Louisiana: Medicaid | Department of   Health | State of Louisiana | Provider Login (lamedicaid.com)  Maine: Provider   Enrollment & Revalidation | Department of Health and Human Services   (maine.gov)  Maryland: ePREP Provider Portal   (maryland.gov)   

Massachussets: MassHealth   Provider Online Service Center (state.ma.us)   

Michigan:  MiLogin   - Login (michigan.gov)   

Minnesota: Login | Provider Hub (mn.gov)   

Mississippi: Mississippi   Medical Assistance Portal for Providers > Home (ms-medicaid-mesa.com)   Missouri: MO   HealthNet Portal (emomed.com)   

Montana: MT.gov   - Sign In (loginmt.com)   

Nebraska: Log   In (nebraskamedicaidproviderenrollment.com)   

Nevada: Nevada   Division of Health Care Financing and Policy Provider Portal > Home   (nv.gov)   

New Hampshire: New Hampshire   MMIS Health Enterprise Portal (nh.gov)   

New Jersey: Welcome to New Jersey Medicaid:   Login 1 (njmmis.com)   

New Mexico: New   Mexico Medicaid Portal (conduent.com)   

New York: eMedNY Homepage   

North Carolina: Login -   NCTracks   North Dakota North Dakota   MMIS Web Portal (nd.gov)   

Ohio: Log   In (maximus.com)   

Oklahoma: HCP   Provider Portal > Home (ohcaprovider.com)   

Oregon: Secure   Site (or-medicaid.gov)   

Pennsylvania: PROMISe™   Internet Portal > Home (state.pa.us)   

Puerto Rico: https://lms.prmmis.pr.gov/   

Rhode Island: HCP   Provider Portal > Home (riproviderportal.org)   

South Carolina: SC Medicaid Portal | SC Medicaid Portal   

South Dakota: Medicaid   Portal (app-dss-sw85pc05dmsproviderenroll.azurewebsites.net)   

Tennesse: PDMS User Log In   (tn.gov)   

Texas: Index (tmhp.com)   

Utah: UtahID   

Vermont: Vermont Medical Portal   (vtmedicaid.com)   

Virginia: DMAS Identity, Credentials   and Access Management (virginia.gov)   

Washington DC: Log In   (dcpdms.com)   

Washington  State: Welcome to MMIS (waproviderone.org)   

West Virginia: Health PAS-OnLine (wvmmis.com)   

Wisconsin: WIMMIS   - Sign In   

Wyoming: Wyoming Department of Health Sign In   (wyomingmedicaid.us)    


We are familiar with Medicare group parts B (855B) and A (855A), provider enrollment. And also individual provider enrollment 855I, 855R and 855O. 

PECOS Logon site: https://pecos.cms.hhs.gov/pecos/login.do#headingLv1


Click the link below to search if the provider is due for Medicare revalidation.

https://data.cms.gov/tools/medicare-revalidation-list


Click the link below to search if the provider is due for Medicare revalidation.

https://www.in.gov/medicaid/providers/provider-enrollment/maintaining-your-ihcp-provider-enrollment/provider-enrollment-revalidation/


MCO/MCE is a Managed Care Organization/Entity. Each state has its own MCO/MCE. They are a government-sponsored healthcare program. They have a contract with the government. Healthcare providers cannot participate in the MCE network unless enrolled and active with the state Medicaid.


To name a few States:


Indiana - Anthem, CareSource, MDwise, and Managed Health Services.

Illinois -  BCBS, CountyCare, WellCare, Aetna Better Health, Meridian Health, Molina Healthcare of IL, and NextLevel Health.

Ohio - Buckeye Community Health Plan, CareSource, Molina Healthcare, United Healthcare,      AmeriHealth, Caritas, Human and Anthem BCBS.

Kentucky - Aetna, Humana, Molina, United Healthcare and WellCare.

Michigan - BCBS, Health Alliance, CareSource, Priority Health, HAP Empowered MI Health Link and      Physician Health Plan.

Wisconsin - Amerigroup, Molina, and Children Community Health Plan


Yes, we know how to update the NPPES or NPI registry. We can also request your NPI number.

Site to search NPI. https://npiregistry.cms.hhs.gov/search


Yes, we know how to verify a provider's medical license if they are active or inactive in all states. These are examples only.

California - https://search.dca.ca.gov/?BD=800&TP=8002

Illinois - https://online-dfpr.micropact.com/Lookup/LicenseLookup.aspx

Indiana - https://mylicense.in.gov/everification/


Yes, we know how to search and verify your DEA or Drug Enforcement Administrator. 

Click this link to check. 

https://apps.deadiversion.usdoj.gov/webforms2/spring/login?execution=e4s1


Yes, we can verify medical doctors board certifications. We cannot verify APNs board certifications.


PECOS is the online Medicare enrollment management system that allows you to: Enroll as a Medicare provider or supplier. Revalidate (renew) your enrollment. Withdraw from the Medicare program. Review and update your information. 


Click this link to log on https://pecos.cms.hhs.gov/pecos/login.do#headingLv1


MAC is a Medicare Administrative Contractor. Each state or region has assigned MAC for Part A and B.

Click this link to see the MAC assigned for your state.


https://www.cms.gov/files/document/macs-state03282023pdf.pdf


EHR is an electronic health record. A digital record of health information. 


EMR is an electronic medical record. An EMR contains the medical and treatment history of the patient. A digital version of a chart. 


CAQH ( Council for Affordable Quality Healthcare, Inc.) is an alliance of health plans, providers, and related organizations working together to make the business of healthcare streamlined and efficient. Click the link below to log on to CAQH.


https://proview.caqh.org/Login/Index


Managed Care List - to name a few

Indiana:

https://www.in.gov/medicaid/providers/files/quick-reference.pdf

Illinois:

https://hfs.illinois.gov/content/dam/soi/en/web/hfs/sitecollectiondocuments/contactinformationforhealthplansformembers05172022.pdf

Ohio:

https://medicaid.ohio.gov/wps/wcm/connect/gov/a6b9e51e-92b1-4041-bc74-b402d78fc957/Who+to+Contact+for+Help+Document.pdf?MOD=AJPERES&CVID=p0d49Qo

Michigan:

https://www.medicaid.gov/Medicaid/downloads/michigan-mcp.pdf

Missouri:

https://mydss.mo.gov/mhd/managed-care-health-plans

California:

https://www.dhcs.ca.gov/individuals/Pages/MMCDHealthPlanDir.aspx


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HEALTHCARE CREDENTIALING AND BILLING

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