Provider Contacts and Resources
Contact Information and Resources for Providers
Provider Helpline
(8am-5pm, Mon-Fri)
- Assistance with claims status and adjudication inquires
- Assistance with Member eligibility, covered services and limitations
- Assistance with regulations, Memos and other communications
- Assistance with claims and billing instructions, service authorizations
Toll Free - 1-800-552-8627
Local 1-804-786-6273
Click the Plus sign next to each subject below to get detailed contact and resource information...
Department of Medical Assistance Services (DMAS)
Department of Medical Assistance Services (DMAS)
1-804-786-7933
1-800-343-0634 (TDD)
600 East Broad Street,
Richmond,
Virginia. 23219
Centers for Medicare and Medicaid Services (CMS)
1-800-633-4227
WAMS
844-482-9267
Managed Care Helpline
1-800-643-2273
ManagedCareHelp@dmas.virginia.gov
Consumer Directed Fiscal Agent – PPL
1-866-259-3009
1-804-200-4001
Email Contacts:
PPLVA@pcgus.com
CDFAS@dmas.virginia.gov
Report Fraud and Abuse
1-800-371-0824
Dental – CardinalCare Smiles
1-888-912-3456
Dentaquest
1-800-233-1468
Service Authorization - Acentra/Atrezzo
1-888-827-2884
1-804-622-8900
PAUR06@dmas.virginia.gov
Providerissues@kepro.org
Transportation – Modivcare
1-866-386-8331
Provider Enrollment
Virginia Medicaid Provider Enrollment Services
PO Box 26803 Richmond, VA 23261-6803
804-270-7027 or 888-335-8476 (Fax)
Email: vamedicaidproviderenrollment@gainwelltechnologies.com
Gainwell Phone - 804-270-5105 or 888-829-5373
MediCall - Automated Voice Response System
MediCall
(24 hours a day x 7 days a week)
Automated Provider access to the following Information:
- Member Eligibility
- Claim Status
- Claim Payments
- Status on Service Authorizations
- Service Limits Information
- Pharmacy Prescriber ID Information
Automated Services
Phone (Richmond Area) - 800-772-9996
Phone (USA) - 800-884-9730
Managed Care Organizations (MCOs)
Managed Care helpline:
1-800-643-2273
MCO Contact Information:
Aetna Better Health of VA | 855-270-2365 |
Anthem HealthKeepers Plus | 833-207-3120 |
Molina Complete Care | 800-424-4524 |
Magellan Behavioral Health | 800-424-4046 |
Sentara Community Plan Cardinal Care Managed Care Helpline | 800-643-2273 |
United Healthcare | 844-284-0149 |
Virginia Premier HealthPlan (Formerly Optima) | 800-643-2273 |
Children’s Health Insurance Programs (FAMIS)
FAMIS, FAMIS MOMS and FAMIS Select
FAMIS & FAMIS MOMS Phone - 866-873-2647
FAMIS & FAMIS MOMS Email - famis@dmas.virginia.gov
FAMIS Select Phone - 888-802-KIDS
FAMIS Select Email - famisselect@dmas.virginia.gov
Pharmacy Point of Service (POS) Support
Virginia Medicaid Pharmacy
(24 hours a day x 7 days a week):
- POS Transmission Issues
- Drug service authorizations
- Preferred Drug List (PDL)
- ProDUR and RetroDU
Helpdesk Phone - 800-932-6648
Electronic Data Interchange (EDI)
Virginia Medicaid EDI Helpdesk
(8am-5pm, Mon-Fri)
- Electronic File Set-up
- File Testing
- EDI Customer Support
Phone - 866-352-0766
Fax - 888-335-8460
Member Helpline
Virginia Medicaid Member Helpline
(8am-5pm, Mon-Fri)
- Assistance with covered services and limitations
- Assistance with claim/payment information
Toll Free - 855-242-8282
Local Phone – 804-786-6145
