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Cardinal Care Provider Pathways
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July 16, 2025
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Providing Care Through Medicaid
Connect With the Health Plans
Have You Connected With Cardinal Care?
Looking for more tips, health resources, and Medicaid updates? Stay connected by following us on social media!
Join our community on Instagram, Facebook, LinkedIn, and YouTube for the latest news, inspiring stories, and helpful tools.
Please bookmark or favorite the Cardinal Care Website.
Revalidate Your Enrollment Today to Avoid Disruption!
Start your enrollment process at the Provider Enrollment home page to start/resume a new enrollment/revalidation. Medicaid fee-for-service and Managed Care Organization (MCO) network providers need to enroll in PRSS and revalidate enrollment at least every five years.
As one of our valued providers, it is important that you complete your revalidation before the due date to avoid disenrollment. Completing your revalidation ensures that you are able to assist Virginians with their needs, such as switching health plans. Please check out the following page for additional information Provider Enrollment & Revalidation | Virginia Medicaid
Please check out any Virginia Medicaid Updates for Providers: Provider Memos & Communications | Virginia Medicaid
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You Asked, We Answered
Question: Where can I find Humana's service authorization information?
Answer: You can find a full list of services requiring prior authorization at the Provider prior authorization and notification lists webpage. This webpage contains a search tool, quick links to submit Medical and Pharmacy requests, and other resources to assist you. You may also call 844-881-4482 and follow the menu prompts for authorization requests, depending on your needs.
Question: Where do we submit DMAS 80s for Humana?
Answer: You can submit the Nursing Facility Admission, Discharge, & Level of Care Change Form (DMAS-80) by fax or email. Fax Number: 8663699535 Email: vamcdtransitioncoordination@humana.com
Question: Are providers required to submit an order, prescription, or request an authorization for enhanced benefits?
Answer: No, providers are not required to submit these but are encouraged to educate members to contact their Care Manager.
Let us know what you want to see in future newsletters by filling out a short survey at the bottom of this email. Click on the thumbs up 👍or thumbs down👎, provide feedback, and then check back each week to see the answers to your questions.
Please only send general questions about Virginia Medicaid, provider
requests should be submitted to the Request Portal.
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Resource Highlight
DMAS has partnered with Virginia Health Workforce Development Authority (VHWDA) to oversee the Graduate Medical Education (GME) program for primary care and high-need specialties targeting underserved areas. For inquiries about the Graduate Medical Education program, including currently funded residency slots and supplemental payments, please visit the VHWDA website. We are currently accepting applications for Cohort 10. Please visit the VHWDA website to attend information sessions and submit your application.
Have You Checked Eligibility Today?
It's important for all Providers to check a member's eligibility each office visit/appointment to ensure the right services are covered, and also to decrease claim denials!
How to check the eligibility or claim status for a member:
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Use self-help service on the MES website. You can create an account if you don't have one by following the instructions on the page.
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Use the Virginia Medical Assistance MediCall System. (Learn how to use MediCall.) The MediCall System offers Medicaid providers 24/7 access to current member eligibility information, check status, claims status, prior authorization information, service limit information, pharmacy prescriber identification number cross reference, and information to access member eligibility and provider payment verification
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Upcoming Meetings and Events
Want to stay updated on the agency? The Virginia Department of Medical Assistance Services (DMAS) hosts many public meetings every month that you are welcome to attend.
For more information about these meetings, visit the Upcoming Meetings page on our website.
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July 18
Children's Health Insurance Program Advisory Committee of Virginia (CHIPAC) | Friday, July 18, 2025 at 10:00 a.m.
- This meeting goes over policies, operations, and outreach efforts for the Family Access to Medical Insurance Security (FAMIS) and children's Medicaid programs.
July 24
Pharmacy Liaison Committee Meeting | Thursday, July 24, 2025 at 10:00 a.m.
- This meeting is comprised of appointed members who meet twice a year to discuss the promotion of cost-effective services to assist Medicaid pharmacy issues impacting the pharmacy community.
July 29
External Financial Review Council | Tuesday, July 29, 2025 at 1:00 p.m.
- The main purpose of this meeting is to review and discuss the most recent Medicaid expenditures to determine the program's financial status.
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Medicaid Highlights and Stories
Aylin is a Senior Advisor at DMAS!
"I love working at DMAS because of the good collaboration of the teams, the guidance given by all staff in support of needs, and overall being able to make a difference in Virginians lives with the work we do," Aylin says about why she loves working at DMAS.
"I believe working at DMAS means that you have the opportunity to help the 2M+ Virginians every day, who need it the most, in all medical assistance services. You can make a difference for those who need medical assistance services, the mission of the agency, and the Commonwealth. It's a win, win, win!"
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Share Your Story
Has Medicaid helped you or someone you know access the care you needed or improved your quality of life? We'd love to hear how Medicaid has made a difference for you or your family.
Share your story with us by filling out a short survey. Selected stories may be featured on our social media accounts to inspire others and show the impact of Medicaid in our community. Your voice matters—help us tell the story of Medicaid's impact!
Check out our social media for a chance to submit photos! You could see your pictures featured in future newsletters and on Facebook and Instagram in our new "Real People, Real Members" initiative.
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