Western Sky Community Care offers a robust provider portal designed to streamline healthcare administration and improve communication between providers and the healthcare network. This digital platform empowers healthcare professionals with efficient tools to manage patient care and administrative tasks.
Official Links
- Provider Portal: Western Sky Community Care Providers Page
- Provider Login: Western Sky Community Care Login
What Providers Can Do
The Western Sky Community Care provider portal enables healthcare professionals to:
- Verify member eligibility
- Manage claims
- Manage authorizations
- View patient lists
- Submit reconsiderations or corrected claims
- Access provider resources and documentation
Who Can Use the Portal
The portal is available for:
- Contracted Western Sky Community Care providers
- Non-contracted providers (after submitting their first claim)
How to Access the Portal
Login Process
- Contracted providers can register now
- Non-contracted providers can register after submitting their first claim
Provider Services Support
Contact Information
- Phone: 1-844-738-5019
- Email: [email protected]
- Hours: Monday-Friday, 8 am – 5 pm Mountain Time
Key Portal Features
Claim Management
- Submit claims
- Check claim status
- Timely filing window: 120 days from date of service
- Indian Health Service (IHS) claims: 730 days filing window
Authorization Management
- Pre-authorization checks
- Medicare pre-authorization
- Medicaid pre-authorization
Additional Resources
- Preferred Drug List
- Provider Directory (PDF)
- Billing Manual
- Practice Guidelines
Privacy and Security
Western Sky Community Care emphasizes:
- Secure login process
- Confidential member and provider information handling
- Compliance with healthcare privacy regulations
Provider Grievances and Appeals
- Must be received within 90 days of Notice of Action
- Resolved within 30 calendar days
- Can address policies, procedures, administrative functions, payment issues, and utilization management decisions
Important Provider Updates
Provider Accessibility Initiative (PAI)
Western Sky Community Care has launched an initiative to:
- Remove barriers preventing member healthcare access
- Improve member health outcomes
- Increase practitioner location accessibility
Supported Healthcare Programs
Western Sky Community Care offers programs for:
- Medicare (for individuals 65 and older, those with disabilities, and patients with End-Stage Renal Disease)
- Medicaid
- Other specialized health insurance programs
Unprovided Information
Some specific details were not available in the source documents, such as:
- Exact registration process steps
- Detailed app download instructions
- Comprehensive portal feature list
The Western Sky Community Care provider portal represents a comprehensive digital solution for healthcare professionals, offering secure, efficient tools to manage patient care and administrative tasks.
Note: Always refer to the official Western Sky Community Care website for the most current information and specific portal instructions.
https://www.westernskycommunitycare.com/providers/login.html
You can upload your documents using the below link to the web portal:https://nmmedicaid.portal.conduent.com/webportal/licenseUpload?lastNodeClicked=804
https://www.westernskycommunitycare.com/providers.html
Once you have created an account, you can use the Western Sky Community Care provider portal to: Verify member eligibility; Manage claims; Manage authorizations