Medicaid Home Health Care Services (HHCS) Electronic Visit Verification (EVV) Project Update
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The purpose of this bulletin is to notify providers that the commencement of the denial of home health care claims for missing EVV data has been extended from 12/1/2023 to 1/1/2024. Currently, claims are being paid regardless of the status of EVV data. DMAS implemented EVV requirements for Home Health Care Services (HHCS) on July 1, 2023, per the requirements of the federal 21st Century CURES Act of 2016. DMAS has published an 837I companion guide on the DMAS website here. This guide is important for your billing systems to submit HHCS claims compliant with Virginia’s EVV requirements.
If you have any questions, please send your inquiry to EVV@dmas.virginia.gov.
Virginia Medicaid Web Portal Automated Response System (ARS) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. | |
Medicall (Audio Response System) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. | 1-800-884-9730 or 1-800-772-9996 |
Acentra Health 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. | |
Managed Care Programs Cardinal Care Managed Care 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. | |
Cardinal Care Managed Care | https://www.dmas.virginia.gov/for-providers/managed-care/cardinal-care-… |
PACE | |
Magellan Behavioral Health Behavioral Health Services Administrator, check eligibility, claim status, service limits, and service authorizations for fee-for-service members. | www.MagellanHealth.com/Provider www.magellanofvirginia.com, email: VAProviderQuestions@MagellanHealth.com,or Call: 1-800-424-4046 |
Provider Enrollment | In-State: 804-270-5105 Out of State Toll Free: 888-829-5373 Email: VAMedicaidProviderEnrollment@gainwelltechnologies.com |
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 |
Aetna Better Health of Virginia | https://www.aetnabetterhealth.com/virginia/providers/index.html 1-800-279-1878
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Anthem HealthKeepers Plus | 1-800-901-0020
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Molina Complete Care
| 1-800-424-4524 https://www.molinahealthcare.com/providers/va/medicaid/home.aspx
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Sentara Family Care | 1-800-643-2273
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Optima Health | Optima Health 1-844-512-3172 |
United Healthcare | 1-844-284-0149
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Dental Provider DentaQuest | 1-888-912-3456 |