Idaho Medicaid — Idaho Medicaid (Healthy Connections / Medicaid Plus / Medicare-Medicaid Coordinated Plan)
| Program name | Idaho Medicaid (Healthy Connections / Medicaid Plus / Medicare-Medicaid Coordinated Plan) |
|---|---|
| Provider portal | https://www.idmedicaid.com |
| FFS claims payer ID | No single canonical ID — routing is fiscal-intermediary-specific. Verify per clearinghouse. |
| Medicaid timely filing | 365 days from date of service |
The federal ceiling for Medicaid timely filing is 12 months under 42 CFR §447.45; most states set a shorter window. Always verify the current policy on the Idaho Medicaid provider portal before filing a late-billing appeal.
BCBS licensee in Idaho
The Blue Cross Blue Shield Association licensee in Idaho is Blue Cross of Idaho + Regence BlueShield of Idaho. See the Blue Cross of Idaho payer guide for payer ID, timely filing, prior auth, and appeal procedures.
Top commercial payers in Idaho
The dominant commercial insurers operating in Idaho, in approximate order of lives covered. Click through for per-payer claims payer IDs, timely filing windows, prior-authorization rules, and appeal procedures.
Medicaid MCOs in Idaho
Idaho Medicaid (Healthy Connections / Medicaid Plus / Medicare-Medicaid Coordinated Plan) contracts with the following managed-care organizations to administer Medicaid benefits in Idaho. MCO contracts dictate claims routing, prior-auth workflows, and appeal deadlines — route each claim by the member's MCO assignment, not the state FFS payer ID.
State-specific regulations affecting Idaho billing
- Idaho Code §41-357 (prompt pay — 30 days electronic clean claim)
- Idaho Code §41-4701 (managed care organization claim payment standards)
- Idaho Code §31-3502 (medically indigent assistance / county indigent program)
Provider licensing & enrollment in Idaho
Providers enroll via Idaho MMIS Provider Portal (Gainwell). Optum Idaho (behavioral) and Molina Dental credential separately.
Major health systems headquartered in Idaho
| Health system | Headquarters |
|---|---|
| St. Luke's Health System | Boise, ID |
| Saint Alphonsus Health System (Trinity Health) | Boise, ID |
| Kootenai Health | Coeur d'Alene, ID |
| Portneuf Medical Center (Ardent) | Pocatello, ID |
| Madison Memorial Hospital | Rexburg, ID |
Frequently asked questions — Idaho billing
What is the Idaho Medicaid program called?
Idaho's Medicaid program is known as Idaho Medicaid (Healthy Connections / Medicaid Plus / Medicare-Medicaid Coordinated Plan). Providers enroll and manage claims through the provider portal at https://www.idmedicaid.com.
What is the Idaho Medicaid timely filing limit?
Idaho Medicaid (Healthy Connections / Medicaid Plus / Medicare-Medicaid Coordinated Plan) requires initial claims to be filed within 365 days from the date of service. The federal ceiling is 12 months under 42 CFR §447.45; Idaho's 365-day window is set by the state provider manual. Late-billing exceptions may be allowed with good-cause documentation — verify on the state portal before filing an appeal.
Does Idaho Medicaid publish a single claims payer ID?
No single canonical claims payer ID is published for Idaho Medicaid (Healthy Connections / Medicaid Plus / Medicare-Medicaid Coordinated Plan). Claims route through the state's fiscal intermediary; look up the correct submitter ID in your clearinghouse directory (Availity, Change Healthcare/Optum, Waystar) and route managed-care claims by the member's MCO assignment.
Who are the largest commercial insurers in Idaho?
The dominant commercial payers in Idaho include Blue Cross of Idaho, Regence, SelectHealth, UnitedHealthcare, Aetna, along with the BCBS licensee Blue Cross of Idaho + Regence BlueShield of Idaho. Each payer's claims routing, timely filing, and prior-auth rules differ — see the per-payer guides linked above.
What Medicaid managed-care organizations operate in Idaho?
Idaho Medicaid (Healthy Connections / Medicaid Plus / Medicare-Medicaid Coordinated Plan) contracts with 2 Medicaid MCOs tracked in the QuickIntell registry, including Molina Healthcare, Optum. MCO contracts determine claims routing and appeal deadlines — route each claim by the member's MCO assignment, not by the FFS payer ID.
What state-specific billing regulations apply in Idaho?
Idaho has 3 tracked state-level statutes that affect medical billing and RCM: Idaho Code §41-357 (prompt pay — 30 days electronic clean claim); Idaho Code §41-4701 (managed care organization claim payment standards); Idaho Code §31-3502 (medically indigent assistance / county indigent program). These sit on top of federal protections such as the No Surprises Act, HIPAA, and 42 CFR §447.45.
Run cleaner claims in Idaho with QuickIntell
QuickRCM, QuickAuth, and QuickERA are tuned to Idaho Medicaid (Healthy Connections / Medicaid Plus / Medicare-Medicaid Coordinated Plan) and the commercial payers on this page — eligibility, prior auth, claim scrubbing, and ERA posting all run on real payer rules, not generic adapters.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. State Medicaid policies, MCO contracts, and payer rules change without notice — always verify against the current provider manual from Idaho Medicaid and the member ID card before submission.