For provider enrollment inquiries, contact the Virginia Medicaid Provider Enrollment Helpdesk by phone at 804-270-5105 or 888-829-5373. Please find contact information for the plans below: . Health PAS-OnLine - Contact-Us Some MCOs began issuing these new cards to members in late 2022. Molina Healthcare of Virginia, LLC Attn: Recoveries Lockbox 401 Market Street Box 780192 Philadelphia, PA 19178-0192 Provider Services phone: (833) 685-2103 Information for Commonwealth Coordinated Care Plus (CCC Plus) and Medallion 4.0 Managed Care Programs. Learn More. Molina Healthcare of Virginia, LLC Molina Healthcare Provider Manual 5 Any reference to Molina Members means Molina Healthcare Members. Both the old and new cards will enable claims processing. You can find our providers in hospitals and clinics near you. Contact us Contact Us Select your state from the menu below: California Members (Medi-Cal): (888) 665-4621 (TTY/TDD: 711) 7:00 a.m. - 7:00 p.m. local time, Monday - Friday Members (Medicare): (800) 665-0898 (TTY/TDD: 711) 8:00 a.m. - 8:00 p.m. local time, 7 days a week. After June 22nd, 2023, TX and WA will no longer have direct access to Molina's Legacy Provider Portal. Check back here regularly for future updates and next steps. Medical Care Management Pre-authorizations 757-552-7540 or 1-800-229-5522 Fax: 757-552-7429 or 1-877-800-2839. Effective September 1, 2020, the following medications require prior authorization: INJECTION, BRENTUXIMAB VEDOTIN, 1MG (ADCETRIS), INJECTION, PEMBROLIZUMAB, 1 MG (KEYTRUDA), INJECTION, TRASTUZUMAB-QYYP, 10 MG (BIOSIMILAR TO TRAZIMERA), INJECTION, TRASTUZUMAB, EXCLUDES BIOSIMILAR, 10 MG (TRAZIMERA). Claims Submission - Molina Healthcare For questions or comments about your coverage, or for more information, please Contact Us. Pick your state and your preferred language to continue. As a Primary Care Provider by designation, you can always access the roster of Molina Marketplace members assigned to your practice via your provider portal. Molina Healthcare appreciates your commitment and dedication to serving our Arizona Medicaid members. By submitting my information via this form, I consent to having Molina Healthcare collect my personal information. With your Molina Medicaid benefits, you'll get standard benefits like: Primary care provider (PCP) and specialist visits PCP visits - Your PCP will provide most of your basic health care. Need to contact us about Optima Health Community Care? How can I obtain eligibility information for a Medicaid beneficiary? How do I find an in network doctor or hospital? ok cancel. Member Services: 1 . IMPORTANT PHONE NUMBERS FOR MEMBERS: Medicaid . You may also learn more about Cardinal Care in this Fact Sheet. Authorization Code Look-Up - Molina Healthcare Virginia's Medicaid Smiles For Children program offers comprehensive dental services to children, through age 20. 1-800-424-4518. 5. You can unsubscribe at any time. 3829 Gaskins Road Richmond, VA 23233 Molina Healthcare & Vendors' Contact Information Claims Department Accessibility You can also print out this flyer or poster to display in your office that explain the new Medicaid ID cards for members. PROVIDER RESPONSIBILITIES 6 . Providers Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? Molina Healthcare is monitoring Coronavirus Disease 2019 (COVID-19) developments on a daily basis. We are always happy to answer your questions about benefits, claims, and prescriptions. The new cards will be active starting January 1, 2023. 2023 Virginia Premier. DMAS - Department of Medical Assistance Services, Breast & Cervical Cancer Prevention and Treatment Act, Hospital Presumptive Eligibility Information, Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Behavioral Health Service Utilization and Expenditures, Monthly Expenditure Reports of the Medicaid Program, Nursing Facility Value-Based Purchasing Program, Medicaid at a Glance by Congressional District, CHIP State Plan and Waiver-Related Documents, Search the contents of the Eligibility Manual, | | s -w-po-ny | | | Deutsch | | Tagalog | Franais | | Igbo asusu | | | Espaol | | Ting Vit | Yorb. How do I access the member portal? 3. Commonwealth Coordinated Care Plus (CCC Plus): 1-800-424-4524 Medallion 4.0: 1-800-424-4518 Molina Healthcare NCQA Accreditation Molina Healthcare is proud to announce we received National Committee for Quality Assurance (NCQA) Accreditation for Medicaid HMO and an NCQA Distinction for Long Term Services and Supports. All other Provider Enrollment inquiries Virginia Medicaid Provider Enrollment Helpdesk Phone 804 270 5105 or 888 829 5373 -804 270 7027 or 888 335 8476 Email: Va.Medicaid.ProviderEnrollment@conduent.com Web Systems (8am-5pm, Mon-Fri) Phone Web Registration (new and registered providers) Click on the link to the forms you need, then download a copy and follow the instructions on the form. Cardinal Care will simplify provider contracting and credentialing processes. Call 911. Emails are responded to within three business days. Information for Financials, Billing and Outreach Materials. In order to register for an account, if you would like access to all group NPIs/APIs under a single Tax ID, please enter your Tax ID only. Virginia DMAS Transportation > Home Member Services: 833-644-1621. Place of Service 12 Place of Service 19 Place of Service 21 Place of Service 22 Place of Service 23 Medicaid Phone Number Tricare Phone Number and Claim Address Molina Healthcare Phone Number claims address of Medicare and Medicaid BCBS Provider Phone Number BCBS Federal Phone Number Ambetter Claims address and Phone Number By using our website, you consent to our use of cookies in accordance with our Privacy Policy. To find information for members about Cardinal Care, please visit the link below. Provider Forms | Medicaid - Molina Healthcare However, you do not need to be designated as a members PCP to provide services to Molina members. We're glad you're part of the Molina Family. Find out more about how this website uses cookies to enhance your browsing experience. By providing your email address, you are opting to receive health plan information and marketing email communications. Non-healthcare (Atypical) providers often need additional guidance with registration and completing the required next steps for using Essentials. Please click on the link below to download a Provider/Pharmacy Directory PDF. We've received your information and a representative will be in touch with you shortly. Heres what to expect: The blue-and-white Medicaid ID cards will still be valid. ENROLLMENT IN MEDICARE ADVANTAGE PLANS 20 Providers will continue to use the DMAS web-based automated response system (ARS), the Medicall telephonic system, and 270/271 eligibility transactions to verify member eligibility and managed care enrollment. Molina Healthcare of Virginia | Richmond VA - Facebook 2023 Molina Healthcare, Inc. All rights reserved. By logging in to this portal, I affirm that I have read, understand and agree to abide by the following terms and conditions: I certify I am a health care provider, an employee of a health care provider, a business associate of a health care provider, or an employee of a business associate, and the purpose of my access to any Virginia Premier System is related to the provision or payment of health care services. DMAS and Medicaid MCOs will provide additional information as we phase in this initiative. Members (Dual Options): (855) 665-4627 (TTY/TDD: 711) MHCSacramentoProviderServices@MolinaHealthcare.com. Medicare. October 1March 31 | 7 days a week | 8 a.m. 8 p.m. April 1September 30 | MondayFriday | 8 a.m. 8 p.m. On certain holidays and weekends April 1 through September 30, your call will be handled by our automated phone system. questions, contact Provider Services at (855) 322-4075. Optima Health 2023, PO Box 66189, Virginia Beach, Virginia 23466. Benefits and Services | Molina Healthcare Passport Health Plan by Molina Healthcare Please visit our Provider Online Directory to validate your information and notify us if there are any updates. Go directly to an emergency room. Box 5028Troy, MI 48007-5028, Behavioral Health ClaimsP.O. Passport members may also call Molina Member Services at 800-578-0603 TTY: 711. The Availity Essentials portal provides access to all portal functions. DMAS - Department of Medical Assistance Services - Virginia Contact Us - Virginia Premier Providers can also contact their managed care health plan for more information. You . Join Our Network | Molina Healthcare If you have questions or need help please, contact our Provider Services department atvphpnetdev@sentara.comor by calling 804-968-1529. Click here. 24-Hour Nurse Advice Line. Information about Virginia Medicaid's technology platform that launched in April 2022 as part of the Medicaid Enterprise System (MES) project, including the Provider Services Solution (PRSS) module. For expedited registration, please provide a Claim number and the Total Billed Charges on the claim when creating your account. Find your provider portal Please call Technical Support for help with Virginia Premiers Provider Portal at 1-877-814-9909 or email connect@healthtrio.com. Health Management Pharmacy and physician administered HCPCS (844) 278-5731 . Here providers can find various resources and information on how to best provide for members Molina Providers are able to access PsychHub online learning courses through their Learning Hub for FREE. (800) 424-4518 TTY: 711 Available Monday through Friday from 8 a.m. to 8 p.m. local time. Contact Us - Molina Healthcare questions and answers for Providers leading up to the MES and PRSS portal launches on April 4, 2022. determine a person's eligibility for Medical Assistance programs in Virginia. Please notify Molina Healthcare at least 30 days in advance when you have any of the following: For providers seeking to appeal to denied Prior Authorization (PA) on behalf of a member only, fax Member Appeals at (844) 808-2407. For managed care assistance, call 800-643-2273 or email ManagedCareHelp@dmas.virginia.gov. Supplemental Dental. 600 East Broad Street Richmond Virginia. Please contact Molina Healthcare Provider Services at MCCVA-Provider@MolinaHealthcare.com. Contact Information | Molina Complete Care Non-Emergency Medical Transportation. 23219For Medicaid EnrollmentWeb: www.coverva.orgTel: 1-833-5CALLVATDD: 1-888-221-1590. EFT/ERA Enrollment QuestionsIf you have questions about enrolling in EFT/ERA, please email EFT_ERA_Inquiry@sentara.com. 23219For Medicaid EnrollmentWeb: www.coverva.orgTel: 1-833-5CALLVATDD: 1-888-221-1590. Virginia Premier is offering EFT services through PaySpan. Who can I contact for further assistance? If you have any questions, please contact the Provider Enrollment Unit at (888) 483-0793, option 3, Monday . Sentara Health Plans, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. Contact your local Molina provider services team. To protect our employees during this time of crisis, we have temporarily moved to a remote workforce. Over-the-Counter (OTC) Benefit. Virginias Maternal and Child Health Insurance Programs, which include Family Access to Medical Insurance Security (FAMIS) and children's Medicaid. All Optima Health plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. CONTACT INFORMATION Molina Complete Care 3829 Gaskins Road Richmond, VA 23233 Provider Services department The Provider Services department handles telephone and written inquiries from Providers regarding address and Tax-ID changes, contracting and training. Need to register for a new account? 23219 For Medicaid Enrollment Web: www.coverva.org Tel: 1-833-5CALLVA TDD: 1-888-221-1590 Where can I find Medicaid member eligibility information? For managed care assistance, call 800-643-2273 or email ManagedCareHelp@dmas.virginia.gov. Members should call the member services number listed on their member ID card or Contact Us. Nurse Advice Line: 833-644-1622 . You can contact the D-SNP's using the contact information below: Health Plan Name Phone Number Website Aetna Better Health 1-855-463-0933 https://www.aetnabetterhealth.co m/virginia-hmosnp/ 600 East Broad StreetRichmondVirginia. 4. Please enter all the mandatory fields for the form to be submitted, For questions or comments about your coverage, or for more information, please, Culturally and Linguistically Appropriate Resources, Provider Education: Opioid Safety & Guidelines, Court Ordered Evaluation and Court Ordered Treatment, AHCCCS Acute and Long-Term Care Drug List, Crisis Response Network Provider Submission Portal Announcement, AzAHP Organizational/Facility Application, Molina Healthcare Prior Authorization and Pre-Service Review Guide, Request for Psychological and Neuropsychological Testing Preauthorization Form, EPSDT Tracking Forms Cover Sheet and Instructions, Pregnancy Termination Form Exhibit 410-5*, Adult System of Care Nine Guiding Principles, Authorization to Use and Disclose (AUD) Form, Childrens System of Care Vision and Guiding Principles, Out-of-Home Placement for Behavioral Health Treatment Checklist, Provider Referral for Care Management Form, Prior Authorization Code/Benefit Exceptions, Prior Authorization Code List (Revised February 1, 2021), Crisis Response Network Provider Submission Portal Visual Reference Guide (. Supplemental Vision. DMAS. Should I provide services only to Medicaid members with a Cardinal Care ID card? If you have questions or suggestions, please contact us. How do I contact Virginia Premier? How do I enroll in a plan for myself or my family? Molina Healthcare can be reached at (888) 483-0793 or (304) 348-3360 or visit their website at www.wvmmis.com. Click here. Member Services: 800-578-0603. 6. Crisis Response Network Provider Submission Portal. During this time, you may experience longer wait times on our phone lines. Contact Us - Molina Healthcare Terms of Use | Privacy Policy | Non-Discrimination Notice | Compliance | Accessibility | Sitemap |HIPAA |Machine-Readable Data. MEMBER RIGHTS AND RESPONSIBILITIES 19 . Network Educators. I agree to keep confidential all information related to Virginia Premier System business, including, but not limited to, quality and risk management activities as well as other confidential or personal information concerning the medical, personal, or business affairs of Virginia Premier System and its members. Molina Healthcare Providers If you are a member and need to discuss details about your coverage or your health, please call us using your plan's phone number. Contact PRSS Provider Enrollment Helpline at (804) 270-5105 or (888) 829-5373, or email Provider Enrollment at: vamedicaidproviderenrollment@gainwelltechnologies.com. All D-SNPs have staff dedicated to assisting members and provider's access services for their members. Visit the Rate Setting page to navigate between specific rate types, as well as to find CPT and HCPC Procedure Codes and Managed Care Capitation information. Contact Us Molina Healthcare | Virginia If you are interested in joining our provider network, we have the information you need to get started. Effective January 1, 2022 Services listed below require prior authorization. Molina Healthcare Providers, Get Started with Availity Essentials Today To make it easier for you to focus on providing great care to our Molina members, weve compiled our provider forms all in one place for you to access. With respect to all information viewed or obtained from this site, I agree to comply with all applicable federal and state laws regarding the confidentiality and integrity of health and medical records. Phone: (866) 606-3889 Website: www.molinahealthcare.alertline.com Contact Us | Magellan Health Provider Forms | Molina Complete Care