Reimbursement for COVID services under Emergency Medicaid after the end of the federal Public Health Emergency
Download PDF
The purpose of this bulletin is to inform providers that automatic coverage for COVID-19 testing, vaccinations, and/or treatment for individuals covered by Emergency Medicaid - as stipulated by Virginia Acts of Assembly 2021 Special Session I, Chapter 476 (HB 2124) - will end on May 11, 2023, due to the end of the COVID-19 federal public health emergency. Prior to the above-referenced legislative requirement, COVID testing, vaccination and/or treatment services were reimbursed only if those services were provided as part of an episode of care that qualified for DMAS reimbursement under Emergency Medicaid. Effective March 23, 2022, COVID-related services could be reimbursed regardless of whether an episode of care qualified for DMAS reimbursement under Emergency Medicaid, as described in a Bulletin published November 3, 2022. Effective May 11, 2023, COVID testing, vaccination and/or treatment services will be reimbursed only if those services are provided as part of an episode of care that qualifies for DMAS reimbursement under Emergency Medicaid.
|
PROVIDER CONTACT INFORMATION & RESOURCES |
|
|
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 |
|
KEPRO Service authorization information for fee-for-service members.
|
|
|
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 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. |
|
|
Medallion 4.0 |
|
|
CCC Plus |
|
|
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 For credentialing and behavioral health service information, visit: 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 |
www.aetnabetterhealth.com/Virginia 1-855-270-2365 1-866-386-7882 (CCC+) |
|
Anthem HealthKeepers Plus |
1-833-207-3120 1-833-235-2027 (CCC+) |
|
Molina Complete Care
|
1-800-424-4524 (CCC+) 1-800-424-4518 (M4) |
|
Optima Family Care |
1-800-643-2273 1-844-374-9159 (CCC+) |
|
United Healthcare |
1-844-284-0149 1-855-873-3493 (CCC+) |
|
Virginia Premier |
1-800-727-7536 (TTY: 711), www.virginiapremier.com |
|
Dental Provider DentaQuest |
1-888-912-3456 |