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DMAP Provider Services

About DMAP Provider Services

Need help?


Email us or call 1-800-336-6016

Learn what our provider customer service center can and cannot do for OHP (Medicaid) providers.

  
Answer
What steps should I take before calling Provider Services for help?
  • Review the resources available on the OHP Tools for Providers page to see if existing resources can answer your questions.
  • Review DMAP’s Provider Contacts List to make sure you are calling the right number for your question.
  • If you identify an error or unexpected denial on your paper Remittance Advice or 835 transaction from DHS, research the problem from your end. Many of the calls DMAP receives about denied claims can be resolved in your billing office (such as coding or modifier errors, wrong claim form or wrong billing provider number). 
  • Review how to read the paper remittance advice. This page also provides information about other ways you can obtain claim status information.
  • Review DMAP’s common billing errors and how to resolve them
What can Provider Services help me with?
  • Interpret DMAP rules and policy to help providers resolve billing issues with DMAP.
  • Help providers with Provider Web Portal access and navigation issues. 
  • Issue new PIN letters for Provider Web Portal and Automated Voice Response access. 
  • Research and resolve "problem claims," CAWEM claim reconsiderations, and pharmacy claim reconsiderations. 
  • Process provider appeals.
  • Coordinate with other DHS offices and partners such as Medical Payment Recovery, Health Insurance Group and DHS case workers to resolve technical issues that affect the provider’s ability to bill DMAP (e.g., incorrect eligibility/enrollment/TPL information).
What can Provider Services NOT help me with?
  • Perform basic claim status, client eligibility and client enrollment inquiries. Please use Automated Voice Response, the Provider Web Portal, or electronic data interchange to get this information.
  • Answer questions about billing, coverage, or prior authorization for services you provide to clients in managed care or coordinated care. You need to contact the client’s OHP health plan for this information.
  • Answer technical questions about issues you have submitting electronic data interchange transactions. You need to contact EDI Support Services (888-690-9888) for this information.
  • Provide training on how to use the Provider Web Portal. Go to the Provider Web Portal page for self-study resources. ​

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