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Virginia Medicaid Web Portal
 
Welcome   Skip portlet
Welcome to the Virginia Web Portal.
For log in or first time user registration, please go to the 'Login' section to the far right.
VARevalidationSchedule   Skip portlet
All Medicaid providers must be revalidated at least once every 5 years under the Affordable Care Act, Section 6401(a).

Click here to see if you are scheduled to receive next month's revalidation letter.
Web Announcements   Skip portlet
ICD-10 Testing

Effective with dates of service October 1, 2015, ICD-10 coding goes into effect. Virginia Medicaid is conducting ICD-10 end-to-end testing with providers, clearinghouses, and other trading partners until September 10, 2015. Failure to submit claims correctly will lead to denials and delay in payment. DMAS will not be issuing advance payments due to lack of provider readiness.
All providers are strongly encouraged to test. Providers who would like to test should send an email to Virginia.EDISupport@xerox.com. For more information, please click on the Provider Resources tab on the Virginia Medicaid Web Portal, and then select ICD-10. Providers should review the ICD-10 Information and FAQs, and the ICD-10 Testing Procedures document.

Fee-for-Service (FFS) claims Incorrectly paid for members enrolled in Commonwealth Coordinated Care (CCC)
FFS claims received between November 2014 and May 2015 were paid in error for members enrolled in the CCC program. These FFS claims will be voided and reprocessed to show the correct denial. The denial will appear on your remittance dated 7/31/2015. Providers may resubmit the claims to the Medicare Medicaid Plan (MMP) MCO for reimbursement. Questions related to the resubmission of these claims should be directed to the appropriate health plan.

Delayed Remittance Scheduled for June 26, 2015
The 2015 Appropriation Act requires that the remittance that normally would be paid on Friday, June 26, 2015 will instead be paid on Friday, July 3, 2015. This annual delay was originally communicated in our Medicaid Memo of May 14, 2010. All claims will be processed as usual based on the date they are received. Furthermore, providers will be able to verify claims status information via MediCall and ARS without disruption. Providers should plan accordingly and prepare for this delay in claims payment. DMAS will not issue advance pays associated with this delay.

NEW - Managed Long Term Services and Supports (MLTSS) Stakeholder Notice
Please read the following important announcement regarding Virginia's proposed managed long-term services and supports (MLTSS) initiatives. Consistent with Virginia General Assembly directives, over the next couple of years, the Department of Medical Assistance Services (DMAS) will transition the majority of the remaining Medicaid fee-for-service populations into coordinated and integrated managed care models. Additional information on DMAS proposed initiatives is available at the following link:
http://www.dmas.virginia.gov/Content_pgs/mltss-home.aspx

Attention Outpatient Hospital (in/out-of-state) Rehab Hospital (in/out-of-state) Providers
Outpatient hospital claims will be reprocessed for dates of service on or after January 1, 2015 and paid prior to February 1, 2015, to reimburse new codes and reduced rates effective January 1, 2015. This action will also correct certain therapy claims and occur beginning April 7, 2015. Providers will see reprocessed claims on remittance advices dated April 17, 2015.

Ordering, Referring or Prescribing (ORP) Claims Edits
Effective with dates of service on or after February 9, 2015 claims edits associated with ORP providers will deny. All ORP providers must be enrolled with Virginia Medicaid and their NPI reported correctly on the claim. Please refer to the original Medicaid Memo dated March 7, 2014 page 2 for Billing Requirements and Edits.

Medicaid Primary Care Rate Increase to Expire
Effective January 1, 2015, the federally funded Medicaid primary care rate increase for qualifying physicians will expire. This temporary increase was part of the Affordable Care Act and was effective for dates of service in calendar years 2013 and 2014. No state funding has been appropriated to continue these payments. This means that reimbursement for dates of service beginning January 1, 2015 will no longer be subject to this temporary increase. The temporary increase was implemented by both DMAS for FFS and by Medicaid managed care plans for managed care services. The additional funding that DMAS paid managed care plans for this temporary increase also expires on January 1, 2015.

Online Enrollment Access

To enroll online you must be logged in as a registered provider. To register, please follow the instructions below.

How to register:

In the Login box click the Provider link. In the First Time User Registration box click the Web Registration link. Enter the requested information and click Continue.
After you are registered and logged into the web portal, click on the Provider Enrollment tab to proceed to the online enrollment applications.

Ordering, Referring or Prescribing (ORP) Provider Enrollment
An Ordering, Referring or Prescribing (ORP) provider is a provider type that does not bill Virginia Medicaid for payment but may order, refer or prescribe to Virginia Medicaid members. If you would like to enroll as an ORP provider, please click on the Provider Services link within the Quick Links box. Next, click on the Provider Enrollment link. Please complete the short registration process and select the Ordering, Referring, Prescribing provider enrollment application from the drop down menu and complete the streamlined application.

WebEx Training Sessions

If you would like to view training sessions on various topics related to Medicaid, please go to dmas.webex.com and select Recorded Sessions on the left panel.
Quick Links   Skip portlet
Sign In   Skip portlet
Log in to the system or register by selecting your role below: