Rate and Rate Setting
You can now view rates by category. Please explore rates and rates setting to view different rates such as hospital rates, nursing facilities, rehab agencies, behavioral health, home health, and more.
Claims and Billing
You asked and we answered! There is separate information for claims and billing related to:
Stay Up to Date on Medicaid Provider Memos and Communications
Looking for the latest DMAS Provider Memos and Communications? Visit our website for updated information.
Want More Information on Enrollment and Revalidation?
As one of our valued providers, it is important that you complete your revalidation before the due date to avoid disenrollment.
DMAS has a new technology platform called the Medicaid Enterprise System (MES). MES is made up of technology modules specific to all areas of Virginia Medicaid and designed specifically for our Provider network. The MES portal offers many resources for Providers, including comprehensive training, revalidation, access to Medicaid memos and bulletins, provider manuals and more.
An important component of MES is the Provider Services Solution (PRSS) module (also known as the Provider Portal), where providers can login and accomplish many DMAS and Medicaid-related tasks, including enrollment and revalidation.
Visit the Provider Enrollment and Revalidation home page for more information.
Get Important Information and Training Resources for Providers
Stay informed and equipped with the latest guidelines, tools, and training materials designed to support you.
If you are looking for key provider resources, you can access valuable information, policy updates, and training opportunities on our Information & Resources page.
Free Interpretation Services for Medicaid MCO Members and Providers
Did you know that Medicaid members enrolled in a Managed Care Organization (MCO) can receive free interpretation services for their medical appointments? Many members and providers are unaware that these services are available at no cost through the Medicaid MCOs.
Medicaid members with limited English proficiency (LEP) or those needing sign language interpretation can request free interpreting services for medical appointments by calling their MCO's Member Services line. Healthcare providers seeing Medicaid members in an MCO can also access these free services, which may include on-site, phone, or video remote interpreting. To ensure availability, requests should be made to the MCO in advance. While timeframes may vary, most MCOs require 3-5 business days for scheduling.
Providing language services ensures that Medicaid members receive quality care, understand their health conditions, and follow treatment plans correctly. By utilizing the free interpretation services available through Medicaid MCOs, providers can improve health outcomes, reduce costs associated with miscommunication, and comply with federal Title VI civil rights laws requiring meaningful access to care.
For more information, Medicaid members and providers should contact their MCO directly:
If you have additional questions about language access, reach out to the Virginia Medicaid Civil Rights Coordinator at CivilRightsCoordinator@dmas.virginia.gov.
Common Questions and Contact Info
How do I verify a member's eligibility without their card?
Who do I contact for billing or claims help?
- For help with billing, claims, eligibility, or regulations, call the Provider Helpline at 1-800-552-8627 (toll-free) or 804-786-6273 (in-state), Monday-Friday, 8 a.m.-5 p.m.
Who do I contact for Enrollment & Revalidation Inquiries?
Where can I find provider reimbursement info?
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