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MES Provider FAQ

Common MES questions and answers for Providers. Click the +Plus signs below to expand the Q&As!

MES Access & Training

Which web browser can I use for MES and MMIS?

You can use any popular web browser to access MES and the Provider Portal.  However, MMIS users should log in to MES using Internet Explorer, and navigate to MMIS is using that browser.

Can I use my old MMIS credentials to access MES on 4/4?

No.  While existing MMIS users will use their current email address, a new password will need to be created.  Look for more about this in a communication this month.

When will I receive my new MES credentials?

You should have received three emails from donotreply@healthinteractive.net explaining the login process.

Yes.  Please see the  MES Provider training area for videos and user guides explaining the login process, including step-by-step instructions.  You can also  view a quick video explaining the process.

How will I access MMIS and the legacy VAMMIS portal?

You can access MMIS by logging in to the MES secure portal and follow the links provided there.  Users can also use this link to temporarily access MMIS.  This access will only be provided for a limited time.  (MMIS login credentials are required to access MMIS)

How do we access to training videos and learning resources for upcoming changes?   Where can we find these, and is training free?

Free training courses and other information on the new system, are now available on the MES Public portal. The training area of the new MES portal can be accessed here.   Look for the Provider Training course link on the right side of the page.

Which web browser can I use for MES and MMIS?

You can use any popular web browser to access MES and the Provider Portal.  However, MMIS users still need to use Internet Explorer.

Primary Account Holders (PAH) and Updating Accounts

We do not know who our Primary Account Holder is, how do we find this information?

For privacy, security and control reasons, only your PAH can access this information.  Please contact the administrative lead or finance office for your organization to determine the PAH for your organization.

Providers who need to assign a primary account holder to their account at the tax identification number level must complete and submit a PAH change form.  Please only submit one form.  Once the PAH is approved and receives credentials that person can assign delegate administrators and delegate users.

How long does it take to process the primary account holder (PAH) request form for provider portal access?

Please allow 7 to 10 business days for a response.  Ensure that you provide all requested information.  If the form is completed incorrectly, please allow 7 to 10 business days to review and approve the corrected submission.

I submitted a PAH form, but I did not receive a response. What should I do?

PRSS is actively reviewing requests for access.  Please allow 7 to 10 business days for a response.  Please do not submit another request.  PRSS will contact you if additional information is needed to grant access.

I need access to the provider portal to check eligibility and submit claims for my provider.  How do I obtain access?

If you have PRSS provider portal credentials, you may access these functions from the PRSS provider portal.  If you do not have provider portal credentials, please contact the primary account holder (PAH) for your organization to grant you access as a delegate.  If you are the PAH for your organization and do not have credentials, please submit a PAH request form to obtain provider portal credentials.

I did not receive my provider portal credentials, what can I do?

If you did not receive provider portal credentials and you are the designated primary account holder (PAH) for your organization, please submit a PAH update form using the new PAH request form.  You can download from here.
If you have additional questions about the form or your portal account access please contact the PRSS help desk at 888-829-5373.

Will we need to set up all users (even those who aren’t delegated with administrative privileges) in the new MES Provider portal or will they be transferred over automatically?

Only the current, active primary account holder will be transferred to the new system, all users (your Delegates for example) need to be set up.  The Primary Account Holder (PAH) must identify and authorize the delegate administrators and/or delegates in the provider portal account.   A great resource to help understand this process can be found on the Provider training page – look for the PRSS-118 Introduction to Provider and MCO Portal Delegate Management.

Do I need to have a Primary Account Holder for each tax ID for my organization?

Yes, Providers must have a Primary Account Holder for each tax ID associated with the provider.

Where can I find the new PAH request form?

The form can be downloaded from the MES Public portal, here.

Who can I call with questions about who our PAH is, or if we need to complete a new PAH request form?

Beginning on 3/21/2022, you can call the PRSS support number at 888-829-5373.  The PRSS team will be available to answer questions regarding provider portal credentials and delegates.

How do I request access to MES and the new PRSS provider portal?

For provider portal access, you must submit a new PAH update/change form.  The form can be downloaded from the MES Public portal, here.  The Primary Account Holder (PAH) must identify and authorize the delegate administrators and/or delegates in the provider portal account.  A great resource to help understand this process can be found on the Provider training page – look for the PRSS-118 Introduction to Provider and MCO Portal Delegate Management.

Physicians/Providers who have accounts that have been locked. Can we get our account unlocked?

For questions about portal accounts, please contact the PRSS support number at 888-829-5373.  

Our account was deactivated due to Inactivity.   How can we reactivate our account?

If your account has been deactivated due to inactivity, the primary account holder (PAH) for your organization will need to complete and submit a PAH change form to have the account reactivated.   The PAH Change form can be downloaded here.

We have been asked to provide only a single email address for our organization’s Primary Account Holder (PAH), is this important?

Yes, all providers with active accounts must designate a single Primary Account Holder (PAH) for each tax identification entity.

Can Provider Organizations with more than one Tax ID use more than one Email Account?

Yes, although these organizations are allowed only one unique email per Tax ID number.

Taxonomy and Remittance Advice

For Waiver Providers - When will the procedure codes and taxonomy codes be available?

Please download the document titled “Waiver Services Taxonomy" from the Downloads page.  This document includes procedure codes based on provider types and specialties and associated taxonomy.   Lastly, it will assist Waiver providers with billing.

For CCC Plus Providers - When will the procedure codes and taxonomy codes be available?

Please download the document titled “CCC Plus Waiver Services Taxonomy Guide" from the Downloads page.  This document includes procedure codes based on provider types and specialties and associated taxonomy.   Lastly, it will assist Waiver providers with billing.

Will specific description/detail fields in the “new” electronic 1500 be available so that the various Electronic Health Record (EHR) and Clearing House vendors can make modifications to allow billing?

There are no "new" electronic fields.   However, the appropriate taxonomy must be submitted on the claim.  Providers should access the new provider portal to validate the taxonomy that is associated with their National Provider Identifier (NPI) and location.

Will providers who do direct-entry billing, continue to use the existing templates (Roll Over)?

Existing templates will “rollover” for Direct Data Entry (DDE) so that providers will not have to set up new ones.   However, the taxonomy code must be updated if different from what was previously used.

Will a taxonomy code be assigned to Providers, or should we choose our own?

DMAS will assign a taxonomy code if the Provider does not provide one.  Providers must provide a valid taxonomy code for their services provided.   They can verify their taxonomy codes that are registered for their NPI(s) on the National Plan and Provider Enumeration System (NPPES) website.

How do I access and download a Remittance Advice (RA) from the provider portal?

RAs can be downloaded in PDF format, after logging into the new Provider portal.

The MES provider document download instructions can be found on the MES Provider training page.  Once there, look for the PRSS-121 course/user guide.  The user guide describes "Remittance Advice" in the Search Criteria.

I did not receive my paper remittance advice (RA).  How do I request a paper RA?

Fee-for-service providers will no longer receive paper remittance advices (RAs) for claims submitted after 8 p.m. March 25, 2022.   Beginning April 4, 2022, the RAs will be available for download in PDF format.

Remittance Advice Note:

Providers may submit a hardship request to receive paper RAs by sending a signed letter on company letterhead to this address:  Virginia Medicaid Provider Enrollment Services, P.O. Box 26803, Richmond, VA 23261-6803.  You can also fax your letter to 1-888-335-8476.  The hardship request should include a reason for the request as well as any efforts the provider is taking to transition from printed to electronic remittances and a timeline for that process.

Payment Pause & Old and New Websites

Will the “pause” in payment mean that no payment will be received on April 8?

Correct.   No payment will be made on April 8.   Instead, claims from March 25, 8:00 pm through April 8, will be reflected in the April 15 payment. This includes Pharmacy.

If we don't get paid on April 8, when will we get paid?

Payments for April 8 will be included in the April 15 payment.

Will the Virginia Medicaid portal (virginiamedicaid.dmas.virginia.gov) we've been using, still be available after April 4?

No, the "legacy" VAMMIS portal is no longer available.

Do I use my existing login credentials for the new MES/PRSS portal?

Existing providers will receive an email from MES toward the end of March inviting them to sign on to the new portal.   These users will be asked to use their existing email address as their credentials.   Users will be asked to choose a new password through this new process.

Provider Enrollment

How can we enroll as a new Provider?

New enrollment applications will be accepted using this link

Will paper applications be accepted for new enrollments or updates after April 4, 2022?

Yes.   There will be a paper application process in PRSS.  Paper enrollment applications will be available the week of April 4.

Is there a re-enrollment process that is needed or will the current enrollment be transitioned?

Yes,   transitioned for current Providers, no re-enrollment is required.

Does the enrollment freeze affect the processing of new individuals who have said they want to come to our service?

Yes.   New enrollment applications will be accepted using this link

Pharmacy Related

How can we determine Member eligibility?

You can call the help line at 800-932-6648.  Give the call center the Members Full Name, DOB, Gender and Race.  They will verify eligibility.

Are there switch fees applicable in the reversal and rebill? 

Yes

If we are unable to determine member eligibility and the pharmacy dispenses under good faith, then later it's determined that the patient didn't qualify - how can we recover the cost? 

DMAS will cover the risk and cost, there will NOT be any liability to the pharmacy.

 

 

12APR22