The Medicaid Provider Profile page shows the Medicaid services provided by your facility, along with the values and effective dates of Medicaid reimbursement calculations.
- To access the Medicaid Provider Profile page, select Go To > Government Payor Research > Medicaid > Provider Profile. The Medicaid Provider Profile page opens.
- In the Select State or Payer drop down list, select WELLMARK_BCBS.
- Select Go.
- Enter the provider’s ten-digit National Provider Identification (NPI) number for the provider you want to review in the NPI or Provider Number field.
- Enter a date in the Effective Date field if you want to view provider profile information for an effective date other than today.
- Click Display Profile. The Medicaid Provider Profile information displays.
Note: To clear the results and return to original Medicaid Provider Profile page, click Reset.
- Review your Medicaid Provider Profile information.
Note: The data that displays on the provider profile varies from state to state.
Wellmark Medicaid Provider Profile
The following table describes the fields on the Provider Profile page for Wellmark Blue Cross Blue Shield (BCBS).
|
Field |
Description |
|---|---|
|
State |
State for the selected provider number |
|
NPI or Provider Number |
Provider’s ten-digit National Provider Identification (NPI) number required on all claims |
|
Effective Date |
Date on which the selected profile went into effect |
| Factors | |
|
Effective Date |
Date on which the selected item went into effect |
|
EAPG Base Rate |
Payer determined; Facility specific Base Rate used for standard EAPG Payment |
|
Grouper Type |
Indicates the grouper type |
|
Grouper Version |
The type of grouper used for this profile |
|
State or Payer |
State or payer for the selected provider number |