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PA Health & Wellness gives all Pennsylvania Medicaid providers the tools needed to provide comprehensive care to their patients. Becoming a contracted Pennsylvania Medicaid provider means you will also receive newsletters and alerts on upcoming education opportunities so that you are always providing superior patient care. Learn more below and become a Pennsylvania Medicaid provider today.
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If you are a contracted PA Health & Wellness provider, you can register anytime. If you are a non-contracted provider, you will be able to register after you submit your first claim.
Once you have created an account, you can use the PA Health & Wellness provider portal to:
- Verify participant eligibility
- Manage claims
- Manage authorizations
- View participant list/roster
- Care Management and Service Coordination information
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Thank you for your interest in becoming a PA Health & Wellness network provider. We look forward to working with you to improve the health of the community.
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PA Health & Wellness offers health insurance programs that fit the unique needs of our participants.
View all of our available programs below.
Provider News
April
How to Create Positive New Habits in our New World
04/29/20
Our lives and routines have changed because of COVID-19. Gyms are closed, parks are closed, shopping trips are limited, and personal hygiene is more important than ever. How can we stay healthy with our habits broken? Here are some tips to help you.March
DRG Letter
03/29/19
Recently, CMS announced changes to the Diagnosis Related Group (DRG) coding that impacts billing for C-Sections and vaginal deliveries. In order to remain compliant with CMS coding guidelines, we are updating our billing instructions for these procedures.January
Provider Authorization Update - Part B Drugs
01/30/19
PA Health & Wellness requires prior authorization as a condition of payment for many services. This Notice contains information regarding such prior authorization requirements and is applicable to all Medicare products offered by PA Health & Wellness.Provider Communication: Authorizations in HHAeXchange
01/14/19
PA Health & Wellness (PHW) is aware of an issue with service authorizations for some PHW participants not being visible in HHAeXchange. We are working to have this corrected and expect resolution early this week.Provider Communication: Important Billing and Claims Notification
01/10/19
PA Health & Wellness is aware of an issue with participant ID cards sent out that may have an incomplete MA ID (less than 10 digits). We believe this only affects participants with an MA ID with leading zeroes (i.e. 0012345678). We are prioritizing the correction of this known issue and will resend participant ID cards to those impacted.December
Provider Communication Policy Update
12/03/18
New policies from PA Health & Wellness will be implemented effective February 1, 2019.November
Medicaid Payment Policy Update for Inpatient Professional Claims
11/26/18
Thank you for your continued partnership with PA Health & Wellness. We value and appreciate the care you give to our Participants. We are updating our Medicaid payment policies for inpatient professional claims.July
Systemic Issue Causing CHC Disenrollment
07/02/18
This notice is to advise CHC providers that a systemic issue was identified for some CHC enrolled participantsJune
Updated Clinical Influenza and Streptococcus Group A Policy
06/21/18
Learn more about our new clinical policy changeMarch
Participant Winter Weather Alert
03/12/18
Severe Winter Weather Alert for Participants