Virginia Network Management Systems Agreement
Description
How to fill out Network Management Systems Agreement?
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FAQ
To check your status, you can log in to your account at commonhelp.virginia.gov by clicking the Check My Benefits button or call 1-855-242-8282 (TDD: 1-888-221-1590).
Medicaid eligibility is reviewed for most individuals once a year. We are able to use a number of electronic sources, and often a worker can renew a member's coverage without additional verifications. If more information is needed, we may ask you to complete a Verification Checklist.
Medicaid Enterprise System (MES) A major component of MES is the Provider Services Solution (PRSS) module. PRSS will be more efficient and make it easier for you to access information you need as a Medicaid provider. Find information and next steps for fee-for-service and managed care providers.
As a result of eligibility expansion, Medicaid is available to Virginia adults under age 65 who earn up to 138% of the poverty level. In 2023, that's $20,120 for a single person, and about $34,307 for an adult in a household of three people).
To change your health plan online, select ?Enroll? and then ?Get Started.? If you want to change health plans by phone, call the Managed Care Helpline, Monday through Friday from a.m. to 6 p.m. at 1-800-643-2273 (TDD 1-800-817-6608).
It is available to people of all ages with incomes below a certain level and people with disabilities. You can apply at any time of year. You have the right to choose Optima Health as your Virginia Medicaid or FAMIS plan.
For assistance with billing, claims, member eligibility, memos and other regulations, call the Virginia Medicaid Provider Helpline at the toll-free (800-552-8627) or in-state (804-786-6273) phone numbers. The Provider Helpline is available Monday to Friday between 8am and 5pm.
Cover Virginia also operates a statewide customer service call center for Medicaid and the FAMIS Programs at 1-855-242-8282. The call center provides general program information, application status, explanation of coverage and benefits, and assistance in resolving application issues.