Rhode Island Medicaid

Please follow the Enrollment Instructions below to become an electronic submitter for Rhode Island Medicaid.

 

Required Documents for those applying for new Submitter IDs

The following online application must be completed and submitted to the Medicaid office prior to initiation of electronic claims submission or inquiry.

 

1. Electronic Data Interchange Trading Partner Agreement

 

To access the application, please click the following link:

 

 https://www.riproviderportal.org/hcp/provider/Home/TradingPartnerEnrollment

 

Then click "Trading Partner Enrollment Application" to begin.

 

We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.

 

Electronic Data Interchange Trading Partner Agreement

  • Please click "Continue" after reading their welcome page

  • Enter your Provider or Business name 

  • Select an identifier from the drop-down (NPI if you have one, if not use your Medicaid ID) then enter that number as the "Identifier" 

  • Taxonomy code is optional so no need to enter

  • CNOM providers please review the additional instructions

  • Press Continue

  • On the following screen enter your contact information

  • Select "Other" in the specify software section

  • Select "Web" as your Method of Transmission

  • Enter your contact information in the EDI Information section

  • In the transactions section select the following:

    • 837P if you send professional claims (CMS 1500)

    • 837I if you send institutional claims (UB 04)

    • 835 if you wish to receive your remittance advice electronically

  • On the following screen please enter all your providers with their name, NPI, and taxonomy code

  • For each provider, check the same transactions you selected above

  • Once done adding all your providers, please click "Continue"

  • On the final screen check the box to accept their terms then enter your name to electronically sign along with your title then press "Submit"

  • Review your information one last time then press "Confirm"

 

Submitting your Forms

It is recommended that you keep a record of the application tracking number so if necessary you can check the status of your application.

 

Waiting for a Response

Once the complete provider enrollment packet has been received, the application will be processed. Processing will take approximately 7-10 days from the date of submission.

 

After processing, an email will be sent to you as notification to begin filing claims electronically. If neither notification, nor a returned enrollment packet is received after 2 weeks, please call their EDI Department at 1-800-964-6211.

 

Testing

Once you have received your Submitter ID and Password from Medicaid, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to Medicaid.

Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.