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Update to Psychiatric Services Manual – Chapter 6

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Memo
Effective Date:

To:
All Providers Participating in the Virginia Medicaid and FAMIS Programs and Managed Care Programs
From:
Cheryl J. Roberts, Director Department of Medical Assistance Services (DMAS)

The purpose of this memorandum is to notify providers that updates have been made to Chapter 6 of the Psychiatric Services Manual. This manual update includes the following changes:

  • Removes outdated language. 

  • Includes updates to reflect existing practices. 

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.

https://vamedicaid.dmas.virginia.gov/

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.

 

 

https://dmas.kepro.com/

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.

https://www.dmas.virginia.gov/appeals/

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

http://www.dmas.virginia.gov/#/longtermprograms

Acentra Health 

Behavioral Health Services

 

https://dmas.kepro.com/

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

 

Anthem HealthKeepers Plus 

http://www.anthem.com/

1-800-901-0020

 

Molina Complete Care

 

1-800-424-4524 

https://www.molinahealthcare.com/providers/va/medicaid/home.aspx

 

Sentara Family Care 

1-800-643-2273

 

Optima Health

Optima Health 1-844-512-3172

United Healthcare 

www.uhcprovider.com/

1-844-284-0149

 

Dental Provider

DentaQuest

1-888-912-3456