Changes to the Provider Portal– Electronic Funds Transfer, Primary Account Holder, and Inactive Accounts
Download PDFThe purpose of this bulletin is to inform providers of changes being made to the DMAS Provider Portal related to inactive provider accounts, provider electronic funds transfer (EFT) change requests, and primary account holder (PAH) change requests. The changes outlined are all effective February 24, 2020.
All provider requests to update Electronic Funds Transfer information must be submitted via paper submission only using the “EFT” form. Providers will no longer be able to make changes to this information via the provider portal after initial registration.
All requests to change/update a provider’s Primary Account Holder must be submitted via paper submission only using the “PAH” form. The DMAS Provider Helpline will no longer be able to make changes to a primary account holder’s information. Both the “EFT” and “PAH” forms have been updated and are available at http://www.virginiamedicaid.dmas.virginia.gov.
Additionally, all account logins that have not had any activity within a 90-day period will be automatically de-activated. All account logins that have not had any activity within a 120-day period will be deleted. If an account is deactivated or deleted, please contact the provider’s primary account holder (PAH) or organization administrator (Org Admin) to assist with updating the account. If the PAH or Org Admin experiences issues, please contact the DMAS Web Support Helpline at 866-352-0496.
The purpose of this bulletin is to inform providers of changes being made to the DMAS Provider Portal related to inactive provider accounts, provider electronic funds transfer (EFT) change requests, and primary account holder (PAH) change requests. The changes outlined are all effective February 24, 2020.
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Medicaid Expansion Eligibility Verification
Medicaid coverage for the new expansion adult group began January 1, 2019. Providers may use the Virginia Medicaid Web Portal and the Medicall audio response systems, as shown in the table below, to verify Medicaid eligibility and managed care enrollment, including for the new adult group. In the Virginia Medicaid Web Portal, individuals eligible in the Medicaid expansion covered group are shown as “MEDICAID EXP.” If the individual is enrolled in managed care, the “MEDICAID EXP” segment will be shown as well as the “MED4” (Medallion 4.0) or “CCCP” (CCC Plus) managed care enrollment segment. Eligibility and managed care enrollment information is also available through the DMAS Medicall eligibility verification system. Additional Medicaid expansion resources for providers are available on the DMAS Medicaid Expansion webpage at: http://www.dmas.virginia.gov/#/medex.
PROVIDER CONTACT INFORMATION & RESOURCES |
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Virginia Medicaid Web Portal Automated Response System (ARS) Member eligibility, claims status, payment status, service limits, service authorization status, and remittance advice. |
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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. |
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Managed Care Programs Medallion 4.0, Commonwealth Coordinated Care Plus (CCC Plus), and the 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 Managed Care Program |
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CCC Plus Managed Care Program |
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PACE Program |
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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 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 |