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The Division of Healthcare Financing administers the Medicaid Program for the Department of Health. They are responsible for financial management, developing policy, establishing benefit limitations, payment methodologies and fees, and performing utilization review

Upcoming Changes to Wyoming Medicaid Operations

As we progress into the New Year, many long-awaited changes are approaching that will bring with them new and improved systems for Wyoming’s Medicaid Providers. These changes are intended to reduce administrative burden for both enrollment and claims processing, and the Wyoming Department of Health is pleased to partner with health information technology enterprise solution companies HHS Technology Group and CNSI to roll these enhancements out to providers and the program.

The first enhancement will be a new provider enrollment system which is projected to go live in spring 2021. All existing enrollments will be carried forward into the new system. All new enrollments, re-enrollments and provider updates will be completed electronically. This will eliminate the need for paper documents to be mailed in with the exception of the paperwork necessary for enrollment with State Auditor’s Office, which will still require hard copy originals. The new provider enrollment website with Wyoming Medicaid provider enrollment information will be available soon.

The next enhancement is scheduled to occur in fall 2021, when CNSI assumes the Wyoming Benefit Management Services (BMS) Medicaid Management Information System (MMIS) as the state’s new fiscal agent.

CNSI’s assumption of Wyoming BMS operations is the most important step toward the State of Wyoming’s effort and goal of replacing the present Wyoming MMIS with its new Wyoming Integrated Next Generation System (WINGS). WINGS involves both system and service-based components as well as modules that together will replace Wyoming MMIS.

Upon completion of this planned transition, CNSI will assume and deliver the following operations-based functions on behalf of the State of Wyoming, its Medicaid System and its providers located throughout Wyoming’s 23 counties:

  • Claims Processing
  • BMS Provider Relations and Member Claims Call Center
  • Provider Outreach and Training
  • Provider Publications and Communications
  • Third Party Liability

Note:   Wyoming Medicaid Providers and stakeholders are encouraged to visit this new Wyoming Medicaid Portal regularly for future updates regarding this planned assumption of operations and its aligned transition activities for BMS. If you have feedback or concerns about this process, they can be submitted here.