CLTS Provider Resources

CLTS

How to Access the Provider Portal

The WPS provider portal is available for CLTS providers. Sign up to obtain access to participant information, authorizations, claims, and secure messaging.

Visit our Providers page, click the Register button and select WPS Health Insurance from the drop-down menu. Complete the Request for Provider Access in its entirety and click the Register button at the bottom.
Providers currently using the portal: Continue accessing the provider portal as you are now. However, if you also service CLTS participants, you will now be able to access their information using the provider portal. Please read on for important information about your account administrator and access privileges.

What do you need to register?
In order to register, you are required to have the following:

Two provider remittance advice (PRA) documents received within the last 90 days
One claim number from each PRA
Remit date and remit amount for each PRA
EFT/check number for each PRA

Are you registering for the first time?
Important message for new providers: The first person to sign up under a tax ID will be the Administrator. This person will be required to invite and approve additional administrators and users under your organization’s tax ID. If you are not the first person at your site to sign up under a tax ID, you must wait for an invitation from the Administrator before signing up as a user.

NOTE: If you have multiple tax IDs, you will need to sign up for the WPS provider portal under each tax ID.

What does the provider portal offer?
The provider portal provides access to:

Dashboard: View provider news and notifications.
Patient Search: Search patient information.
Authorizations: Search for authorizations and check authorization details.
Claims: Search for claims, check claims detail and corresponding Provider Remittance Advice (PRA), and submit claims electronically.
Secure Messages: View and send secure messages to the WPS Contact Center.
Profile Management: Change your security questions and password and set your preferences. Provider Administrators also can invite additional users under your organization’s tax ID and access the user signup queue to approve invitations.
FAQs: Access frequently asked questions related to CLTS claims submission.

NOTE: If you are a CLTS provider only, do not use the referrals, extras, and Find a Doctor links on your dashboard.

WPS is the Third-Party Administrator for the Children's Long-Term Support (CLTS) Waiver Program. WPS provides claims processing administration, a contact center, reporting, provider outreach, and other services.

Understanding the CLTS Waiver Program Statewide Uniform Rates

On July 1, 2019, the Children’s Long-Term Support (CLTS) Waiver Program began to use statewide rates for specific services to comply with federal regulations. Uniform statewide rates are more consistent and transparent for providers and for children with disabilities and their families.

Provider Communications

CLTS Waiver Provider Checklist
Rate Setting Provider Letter
Group Service Code Information for dates of service July 1, 2020, and after:

Group service codes must be billed with the authorized service code and modifier(s)
In addition, the group size modifier of UN (two children) or UP (three children) must be billed on the claim based on the group size
Group service codes must be billed with the provider's usual and customary rate based on the group size of two or three children (service authorizations on the WPS provider portal will not list a rate)
If only one child is present for the group, providers must request a new authorization

Please visit the following DHS links to learn more.

Children’s Long-Term Support Waiver

Electronic Claims Filing:

WPS Corporate Services-EDI would like to make sure you understand the available cost-effective options for electronic transactions. Taking the step to go paperless is an efficient way to reduce your costs and speed up your reimbursements. Your savings and satisfaction are important to us, so don’t hesitate to call or email if you would like to discuss your available options. Our EDI staff is here to help you learn how to utilize electronic transactions, which will save you time and money in the process. Please choose your organization below to see your customized options.

Step 1: Choose your claim filing option

Option 1: PC-ACE Pro 32

WPS offers and supports this free software you can use to submit claims electronically. This software also provides an electronic process to receive claims status, perform eligibility searches, and view/print an Electronic Remittance Advice (ERA) in place of paper Provider Remittance Advice (PRA). Please call WPS EDI for more information on the initial setup of this option.

Option 2: Contact a clearinghouse or billing service to submit claims on your behalf.

If neither of these options will fit your needs, please contact us and we can discuss other options with you.

800-782-2680, option 1
Email WPS

Step 2: Register on WPS Community Manager (Option 1 and 2 only)

This will register you in our system and assign you a WPS EDI Submitter ID to send claims directly to WPS.

Note—If you are using an approved clearinghouse, you do not need to register for WPS Community Manager.

Option 3: Spreadsheet Submission

This is a fast and easy way for providers to submit paperless claims. You must have access to and knowledge of Microsoft Excel or similar spreadsheet software.

Electronic Funds Transfer (EFT):

Improve efficiency and go green with our EFT direct deposit service. When you use EFT, you no longer have to wait for paper checks to be delivered through the mail. Instead, your payment is deposited right into your checking or savings account. This environmentally responsible electronic process eliminates the use of paper.

Electronic Remittance Advice (ERA):

The quickest and most efficient way to receive your Provider Remittance Advice (PRAs) is through ERA, which is an electronic version of a payment explanation. ERA is more convenient for you. When you sign up for EFT and ERA, you will find out about your payment via ERA about two days prior to the funds transfer. Once you enroll for ERA we will suppress your paper PRAs for even further paper savings.

Change Healthcare's Payer Enrollment Services—FAQ

Enrollment questions?
Call Change Healthcare at 800-956-5190
Monday—Friday, 8 a.m. to 5 p.m. CT

Remember, we are here to assist you in any way we can to help transition you to an electronic cost-effective health insurance partner.

Children’s Long-Term Support Waiver Program Informational Documents:

Webcast Resources

The objective of these webcasts is to provide an overview of the following key informational subjects:

Required claims data elements when submitting claims to WPS
Claim submission options (electronic or paper)
Corrected claim procedures
WPS contact information

View Authorizations Webcast
CLTS Remote Services Billing

Contact WPS EDI

800-782-2680, follow prompts
Email EDI

CLTS Resources

877-298-1258
Email WPS CLTS
CLTS Website