Please follow the Enrollment Instructions below to become an electronic submitter for Wyoming Medicaid.
The following are required enrollment documents that must be completed, signed, and returned to the Medicaid office prior to initiation of electronic claims submission or inquiry.
Please go to:
Download and complete the following:
- Wyoming Medicaid EDI Application
- Trading Partner Agreement
Please follow the instructions carefully to avoid delays in processing the EDI Information.
YOU are the Provider
YOU are the Trading Partner
We are NOT a clearinghouse or a billing service and our information is not going to be entered anywhere on this form
You are applying for a Trading Partner ID for yourself
Your Medicaid Number is your Provider ID/Provider Number
Please complete the forms with blue ink
If you have any questions about your Wyoming Medical Assistance Program EDI enrollment, please call Wyoming Medicaid's EDI department at: 1-800-672-4959.
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.
Medicaid EDI Application
Complete Sections 1-3 on page 1 with your Business/Provider and contact information
On page 2, if you wish for your electronic EOBs to be delivered to your Inbox in ClaimShuttle, put an X for "I will retrieve my 835" otherwise, choose "I do not wish to use the 835 at this time"
Please complete page 3 with the following:
If you have an existing Trading Partner ID, please enter it in the Trading Partner ID section for question 1. If not, please skip that question
Please select the option for "Secure Web Portal"
Trading Partner Agreement
Please complete the Submitter section with your information
If you have a Trading Partner ID enter it in the first line, if not please enter your Medicaid Provider Number
Submitting your Forms
It is recommended that you keep a copy of all the forms you will be submitting for your records.
Mail the enrollment forms reflecting original signatures to:
Attention: EDI Enrollment
P.O. Box 667
Cheyenne, WY 82003-0667
Waiting for a Response
Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately two weeks from the date of receipt. (Remember that mailing time can take as much as five days.)
After processing, a confirmation will be sent to you as notification to begin filling claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact EDI Technology Support Center at 1-800-672-4959.
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.