Wyoming Dental

Medicaid of Wyoming  

  • Direct Link
  • Claims Processed through ACS EDI Gateway
  • Call (800) 672-4959 as early as 6 business days after form submission to check status of enrollment  
  • Both ACS forms below must be completed in order to set up electronically
  • When you are enrolled for WY Medicaid you are enrolled for DME, Just set up in Claimstaker
  • Payer ID WYMCI (Regular Medicaid)
  • Payer ID WYMDE (Medicaid DME)

ACS Trading Partner Agreement

ACS Authorization Form— Only the first page of this form needs to be filled out and sent in

National Payers Requiring Enrollment


  • Direct Link
  • Payer ID – 89070 and 54771
  • If the office does not have a provider ID:
    • The office needs to call UCCI at (800) 633-5430, option 3, and let UCCI know that they will be submitting claims through Apex EDI.   Be sure to have them acknowledge every provider in the office that submits claims to UCCI.
  • If the office knows their provider ID you can submit the online form for them:
  • To Enroll for ERA’s:

Other National Payers Enrollment Forms