NH Medicaid Provider Information
State Medicaid agencies are required to revalidate all provider types under directives in Section 6401(a) of the Affordable Care Act (ACA) and in accordance with 42 CFR 455.414. New Hampshire Medicaid requires their providers to revalidate their enrollment criteria in the Medicaid Management Information System (MMIS) within 5 years from enrollment.
New Hampshire’s provider revalidation will be done in phases, beginning in March 2017. Providers will be notified via letter if they are part of Phase I. Providers should not take any steps to revalidate until they receive their revalidation notification letter in the mail.
It is important that providers keep their mailing address information up to date in the MMIS to ensure that they receive the notification letter. To update your address, please complete and mail in the Change of Provider Information Form located under Documents and Forms in the MMIS Portal. The Provider Service Center cannot update your address via phone but can confirm the address of record. Please call the Provider Service Center if you have questions: 866-291-1674. Providers need their seven-digit NH Medicaid ID number to access the Service Center.
Please continue to check this page for updates on the revalidation process.
General Information for Providers
All providers of NH Medicaid covered services must be enrolled as a NH Medicaid provider with Xerox to bill medical or pharmacy claims for NH Medicaid recipients. You can contact Xerox via their website https://nhmmis.nh.gov or call them at 1-866-291-1674 or (603) 223-4774 to become an enrolled provider.
If you have questions on if a NH Medicaid covered service requires a prior authorization (PA) please visit Xerox's website and select downloads to obtain all prior authorization forms for services.
If you have questions on prescription drug coverage and clinical prior authorizations please visit Magellan's website at: https://newhampshire.magellanmedicaid.com.
To check eligibility for a NH Medicaid recipient please call 1-866-291-1674 and follow the prompts.
- KePro Introduction Letter to Providers
- Pharmacy Benefits Management
- Clinical Prior Authorization
- Magellan Medicaid Administration
- Medicaid Electronic Health Record Incentive Program
- NH Medicaid Health Information Technology Program
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