For Providers

Please take notice that on October 21, 2015, the Insurance Commissioner of the State of Wyoming (the “Commissioner”) was appointed by the District Court, First Judicial District as Receiver of WINhealth Partners (the “Company”) pursuant to Statute 26-28-105(a)(i) and (ix) of the Wyoming Insurance Code.  The Commissioner has the responsibility to take these actions whenever a company is deemed to be statutorily impaired.
 
In the best interest of our members, individual coverage will remain in effect through December 31, 2015, at which point each individual will need to move to a new plan with a different carrier. Individuals can shop for a plan through www.healthcare.gov, by contacting a navigator at 2-1-1, or by working through an insurance agent. All claims submitted for these members will continue to be processed through the run-off period.
 
Group plans also remain in effect through December 31, 2015. WINhealth and the Department of Insurance are working with groups to find alternative coverage. Groups are encouraged to start looking at their options immediately and can make the switch to a new plan with a different carrier at any time. We will continue to honor coverage and process claims for groups through the run-off period.
 
This event does not signal a change to your provider participation status with WINhealth. You should continue to see our members through this transition period. We will continue to keep you updated as the wind down process evolves and circumstances warrant.

Click here for a list of FAQs. 

 

We’re Here to Help

If you have any questions or would like to learn more information about WINhealth’s Provider Network, or if you have any questions about WINConnect, please don’t hesitate to contact us at 800-868-7670 or by email at professional_services@winhealthplans.com.

We will send you a packet of information containing:

  • A fee schedule for your office location
  • A Preferred Provider participation agreement
  • A credentialing information form
  • A postage paid return envelope

Additionally, you can download a copy of the WINhealth Provider Manual, which contains information on virtually every provider-related topic.
 

WINConnect Provider Portal

The WINConnect Provider Portal gives you 24/7 access to important patient information – such as checking patient eligibility and the status of claims you’ve submitted.

Additionally, you can use WINConnect to send secure messages directly to WINhealth – and you may complete and submit preauthorization requests as well.
 

Using WINConnect

Getting started with WINConnect is easy. Simply “Register” or, if you’re already registered, click the "WINConnect Login" button at the top of your screen to login.

Once you’re on the WINConnect Portal, you may utilize the following resources:

Eligibility Search: This screen allows you to review detailed eligibility and benefit information for an individual patient, including co-pay, coinsurance and deductible amounts, and preauthorization requirements.

Claims Status Detail: This screen allows you to view whether a claim has been received, and if so, when it was received and its current status. If the claim has been paid, you will see the check number and detailed payment information.
 

Safe and Secure

The WINConnect Portal’s email messaging function guarantees that your patients’ HIPAA-protected information will always be transmitted securely.

Additionally, the portal provides a secure, efficient way to electronically send many of the forms that your staff currently completes by hand and faxes to us (like preauthorization requests).