DMAS Transition from VAMMIS To Medicaid Enterprise System (MES) Reminders and Frequently Asked Questions Answered
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This is the third Medicaid bulletin intended to inform Medicaid fee-for-services providers about the upcoming transition of several key information management functions currently handled through the Virginia Medicaid Management Information System (VAMMIS) to a new technology platform called the Medicaid Enterprise System (MES). Beginning April 4, providers will be required to use the new MES to access all functions described in this bulletin.
Reminder: VAMMIS will be off-line from March 30 through April 3, 2022
Several functions within the existing VAMMIS website will be temporarily off-line beginning Wednesday, March 30, 2022, resuming Monday, April 4, 2022. Please review two previous MES information bulletins posted on March 4, 2022, and March 11, 2022, for additional information on this systems pause. The bulletins can be found on the DMAS website at https://www.dmas.virginia.gov/for-providers/medicaid-enterprise-system/fee-for-service-providers/. Or at the new MES portal at: https://vamedicaid.dmas.virginia.gov/provider
There will be no disruption in enrollment or financial eligibility for our Medicaid members during this pause to VAMMIS. During this temporary pause, providers should continue to provide all health care services to Medicaid members who present proof of eligibility in the form of a blue and white Medicaid ID card, a notice of approved eligibility from the Department of Social Services or a card for a managed care health plan.
The MES Provider Portal will replace VAMMIS beginning April 4, 2022
Beginning April 4, providers will be required to use the new MES Provider Portal to access the following functions:
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Frequently Asked Questions and Answers
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Am I a fee-for-service provider? |
On or after April 4, 2022, call the PRSS Provider Help Desk at 888-829-5373. |
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How do I request access to the MES Provider Portal? |
Watch training video External MES Users – Accessing the System (MES 103) to learn how to request access to MES. https://vamedicaid.dmas.virginia.gov/training/providers
Download the MES Provider Portal User Guide (PRSS-120)) https://vamedicaid.dmas.virginia.gov/sites/default/files/2022-02/PRSS-120_Provider_Portal.pdf |
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How do I use the MES Provider Portal? |
Watch training video Provider Portal Overview (PRSS-121) for Provider Account Holders and Provider Delegates. This provider training will show you how to troubleshoot registration issues, access and navigate the Provider Portal, and maintain provider information. |
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How can I determine who is listed as our Primary Account Holder (PAH)? |
Beginning March 21, 2022, you will be able to access provider support through Gainwell Provider Services 888-829-5373. If you need to create or update your PAH, the PRSS form will be available on the MES public portal on March 21, 2022. |
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If we were unable to update/access our VAMMIS account by the deadline, what can we do? |
If you were unable to access your web-portal account to make the requested PAH email and phone updates by the deadline, please submit the PRSS PAH update/change form beginning March 21, 2022. The PRSS form will be available on the MES public portal on March 21, 2022. |
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Can you advise how we should assign the correct person to manage a provider “account” and if there needs to be a different person who is responsible for each facility provider? |
There must be one PAH assigned to each unique provider entity (each separate tax identification number). In the case of a group or facility provider made up of multiple affiliated providers, this would mean a primary account holder for each unique provider entity affiliated with the group or facility, and for the facility entity. (A single individual may perform the role of PAH for multiple providers.)
The PAH is responsible for managing all other users that have access to a specified provider account in order to perform one or more functions through the MES Provider Portal (e.g., claims submission). These other users are referred to as delegate administrators or delegates, depending on the level of access granted to them by the PAH.
Complete course Introduction to Provider and MCO Portal Delegate Management (PRSS-118) and download the Provider Portal User Guide (PRSS-118) |
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If one individual is acting as PAH for multiple provider accounts, does this individual have to have a separate (unique) email address for each provider account? |
No. A PAH may use the same email address with multiple accounts, but may only enter one contact email address per account for each tax id number. Each NPI does not require a unique email address. |
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Is there a need to assign an EDI administrator to manage EDI transactions? |
Yes. The EDI Administrator is a new role available within the MES. The primary account holder will be able to assign this role in the new system. |
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Will a currently enrolled provider’s account information transfer from the VAMMIS website to MES? |
Yes. For a provider that is already enrolled as a Medicaid fee-for-service provider, information currently stored in VAMMIS will be transferred to the new MES. |
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Will currently enrolled providers have to revalidate their enrollment through the new MES Provider Portal? |
No. DMAS will not require currently enrolled providers to revalidate specifically for the transition to MES. |
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What impact, if any, is the MES transition going to have on a provider’s enrollment effective date? |
After the transition to MES, DMAS will check provider enrollment information to ensure accuracy. If a provider’s revalidation due date fell during this period of transition, the due date will be moved to July 4, 2022, or after. You will receive notice at least 90-days prior to your new revalidation date. |
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How do I enroll as a Medicaid Provider? |
Download the MES Provider Portal User Guide (PRSS-120) https://vamedicaid.dmas.virginia.gov/sites/default/files/2022-02/PRSS-120_Provider_Portal.pdf
Complete live virtual session Provider Enrollment Application (PRSS-111) and watch training video Individual Enrollment Overview (PRSS-113) |
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How do I enroll a new individual-within-a-group provider |
Watch training video Individual Within A Group Enrollment Overview (PRSS-112) |
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How do I enroll a new ordering, rendering and prescribing provider? |
Watch training video ORP Enrollment Overview (PRSS-114) |
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How do I enroll a new group provider? |
Watch training video Group Enrollment Overview (PRSS-115) |
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How do I enroll a new facility/organization provider? |
Watch training video Facility/Organization Enrollment Overview (PRSS-116) |
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How to enroll a new Atypical provider and register to use the portal? |
Watch training video Atypical Enrollment Overview (PRSS-117) |
For more information, including more Frequently Asked Questions, please check out the MES Public Training Area at https://vamedicaid.dmas.virginia.gov/training
MES-related questions may be sent to AskMES@dmas.virginia.gov
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PROVIDER CONTACT INFORMATION & RESOURCES |
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KEPRO Service authorization information for fee-for-service members. |
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Provider Appeals DMAS launched an appeals portal in 2021. You can use this portal to file appeals and track the status of your appeals. Visit the website listed for appeal resources and to register for the portal. |
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Managed Care Programs Medallion 4.0, Commonwealth Coordinated Care Plus (CCC Plus), and Program of All-Inclusive Care for the Elderly (PACE). In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider. The managed care plan may utilize different guidelines than those described for Medicaid fee-for-service individuals. |
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Medallion 4.0 |
https://www.dmas.virginia.gov/for-providers/managed-care/medallion-40/ |
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CCC Plus |
https://www.dmas.virginia.gov/for-providers/managed-care/ccc-plus/ |
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PACE |
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Magellan Behavioral Health Behavioral Health Services Administrator, check eligibility, claim status and service authorizations for fee-for-service members. |
www.magellanofvirginia.com, email: VAProviderQuestions@MagellanHealth.com,or Call: 1-800-424-4046 |
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Provider HELPLINE Monday–Friday 8:00 a.m.-5:00 p.m. For provider use only, have Medicaid Provider ID Number available. |
1-804-786-6273 1-800-552-8627 |
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Aetna Better Health of Virginia |
https://www.aetnabetterhealth.com/virginia/index.html 1-800-279-1878 |
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Anthem HealthKeepers Plus |
https://mss.anthem.com/va/virginia-home.html 1-800-901-0020 |
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Molina Complete Care |
1-800-424-4524 (CCC+) 1-800-424-4518 (M4) |
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Optima Family Care |
https://www.optimahealth.com/medicaid 1-800-881-2166 |
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United Healthcare |
https://www.uhccommunityplan.com/va 1-844-752-9434, TTY 711 |
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Virginia Premier |
1-800-727-7536 (TTY: 711), https://www.virginiapremier.com/ |