Updates to Brain Injury Services (BIS) Targeted Case Management (TCM)
Download PDF
The purpose of this bulletin is to notify providers that DMAS is now allowing providers licensed by the Department of Behavioral Health and Developmental Services to be providers of brain injury services case management. This will allow Community Services Boards and Behavioral Health Authorities to support the BIS TCM program and help facilitate the BIS TCM program’s implementation.
DMAS implemented the Brain Injury Services Targeted Case Management program in accordance with House Bill 680 of the 2022 legislative session and the 2022 Appropriations Act. Brain Injury Services Case Management is designed to provide service coordination and person-centered planning with members 18 and older who have sustained a traumatic brain injury.
Prospective providers can continue to submit enrollment applications to the Medicaid Enterprise Solutions (MES) provider enrollment portal. For more information on how to enroll as a provider please refer to the MES portal HERE.
These changes will also be communicated in a forthcoming Brain Injury Case Management Services provider manual supplement update posted in the MES Provider Manual Library under the CCC+ Waiver, DD waiver, and ART Services manuals HERE.
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 |
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 | |
Acentra Health Behavioral Health Services
| |
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 | 1-800-901-0020
|
Molina Complete Care
| 1-800-424-4524 https://www.molinahealthcare.com/providers/va/medicaid/home.aspx
|
Sentara Community Plan | 1-800-881-2166 https://www.sentarahealthplans.com/providers
|
United Healthcare | 1-844-284-0149
|
Dental Provider DentaQuest | 1-888-912-3456 |