Western Sky Community Care: Secure Provider Portal Access for Healthcare Professionals

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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

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

  1. Contracted providers can register now
  2. 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

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