If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850. Your plan will send you a bill for the plans premium. Optima Health Community Care Contact Information, 24Hour Interactive Voice Response757-552-7474 or 1-800-229-8822, option 2, Medical/LTSS ClaimsP.O. Newsletters Access the latest health care news and updates from Virginia Premier. PRSS 121 Provider Portal Overview . Task Force on Primary Care. Find out more about how this website uses cookies to enhance your browsing experience. Utilization Management. NET is a service that is provided to Georgia Medicaid Members who require transportation assistance to Medicaid-billable healthcare services and have no other means of transportation. If you are interested in joining our provider network, we have the information you need to get started. Contact PruittHealth Premier or Provider Services and get answers to questions you have about our plans, services, and benefits. We join technology and smart business practices to offer a new standard in human transportation delivery services. Participating providers can find more precertification phone numbers in Participating provider precertification list for Aetna (PDF). Virginia Premier CompleteCare is a health plan that contracts with both Medicare and the Virginia Department of Medical Assistance Services to provide benefits of both programs to enrollees. Between October 15December 7 each year (for coverage starting January 1), Within 3 months of first getting Medicare, In certain situations where youre allowed to join or switch plans, Your Medicare Number (the number on your red, white, and blue Medicare card). How To Apply For Medicaid. If you want to join a plan but have no permanent residence, a Post Office Box, an address of a shelter or clinic, or the address where you receive mail (e.g., social security checks) may be considered your permanent residence address. Tell the agent that you want a language interpreter to join the call. MyVA411 main information line. W9 Submission Please send your completed W9 to vphp_pdmsupport@virginiapremier.com Provider Inquiry Line Call our Provider Inquiry Line at 1-800-727-7536 (TTY: 711) Contact your local provider Relations Manager to get detailed information about insurance requirements in your state. Hours: 24/7. GOT A STORY? Since this is a shared-ride service, it is possible that you will ride with other passengers picked up at or near your pick-up location. Please click here to view. Virginia Premier Health Plan Phone -855 652 8249 Phone -800 600 4441 Phone -800 901 0020 Phone - 800-279-1878 -844 374 9159-855 249 5025 Call the Southeastrans number that corresponds to your county. Riders are only able to carry one bag onto the vehicle; bag must fit in riders lapno exceptions. Virginia Premier Partners Labs (except for CLIA approved labs on the in-office lab list) Lab Corp: 1-800-873-7251 SolstasLabs: 1-888-200-4775 Routine Vision VSP: 1-800-877-7195 Dental (Smiles for Children and MLTSS Enhanced Benefits) DentaQuest: 1-844-822-8115 Pharmacy Retail and Specialty Envision: 1-855-872-0005 Pharmacy Help Desk: 1-855-408-0010 Radiology (CT, CTA,CCTA, MRI, Here is a general overview: . The additional areas of documentation include, but are not limited to, the following: b) effective date, expiration date, and coverage, a) effective date, expiration date, and coverage, b) All Owned, Hired, and Non-Owned coverage. Southeastrans contracts with independent transportation providers to deliver a range of transportation services within our transportation service programs. Read about your fellow providers as we celebrate our network and all the work that you do for our members. CLICK HERE TO SHARE YOUR TESTIMONY. The items in Section 2 are optional you cant be denied coverage because you dont fill them out. As a Transportation Broker, we know that it requires great providers to provide great, safe, and timely transportation experiences for our members. Some drugs and/or procedures require prior authorization before Virginia Premier will cover the cost. Our secure provider portal is available 24 hours a day to assist you with accessing data quickly and easily. We offer translator services in nearly 200 languages. TTY users can call1-877-486-2048. See What happens next? on this page to send your completed form to the plan. The Task Force's goal is to find solutions and support for providers during the COVID-19 pandemic. Email: Name: Phone: Aetna: Aetnabetterhealth-VAProviderRelations@aetna.com: RJ Dix, Provider Relations Manager: 855-652-8249: Anthem: AnthemEVVProviders@Anthem.com . INFO AT A GLANCE MembersProvidersFacilitiesCovid-19 Information HubReport Fraud, Waste, and Abuse, Company Overview Leadership Team Our Services Careers SETI News, Southeastrans, Inc. 4751 Best Road, Suite 300, Atlanta, Georgia 30337. People with Medicare who want to join a Medicare Advantage Plan. We want to help you improve the premier health outcomes of our members by reducing the time you spend on claims follow-up. En espaol: Llame a PruittHealth Premier al 1-855-855-0668 (TTY 711) 1-855-855-0759 (TTY 711) 1-855-855-0759 (TTY 711)o a Medicare gratis al1-800-633-4227y oprima el 2 para asistencia en espaol y un representante estar disponible para asistirle. If a need exists within your service area, Southeastrans will contact you for an interview and request that you proceed with Step 2 of the application process. Looking to join our network as a Transportation Provider? Call PruittHealth Premier at 1-855-855-0668 (TTY 711) 1-855-855-0759 (TTY 711) 1-855-855-0759 (TTY 711). Nondiscrimination Notice. Providers can reach out to Medicaid managed care organizations if you have questions. Telecommunications Relay Services (using TTY) 711 Hours: 24/7. EFT/ERA Enrollment QuestionsIf you have questions about enrolling in EFT/ERA, please email EFT_ERA_Inquiry@sentara.com. If you want to join a plan during fall open enrollment (October 15December 7), the plan must get your completed form by December 7. 23219For Medicaid EnrollmentWeb: www.coverva.orgTel: 1-833-5CALLVATDD: 1-888-221-1590. 2021 PruittHealth Premier All rights reserved, CMS ID Number: H3291_Website, H6345_Website, Last modified: November 4, 2022 10:36 AM. Here is a list of contacts who can assist you: . ATTENTION ALL PRUITTHEALTH PREMIER PROVIDERS: Hurricane Ian Response. Then view our compliance checklist below of items required to become a provider. Commonwealth Coordinated Care Plus (CCC Plus): 1-800-424-4524. Click here for a map of the current service areas and Provider Relation Managers for Virginia. Members should call the member services number listed on their member ID card or Contact Us. DMAS - Department of Medical Assistance Services. Travel outside a members home community is available only when those specialized services are not available within members home community. Then click here to fill out our online Request for Qualification Form. You can schedule up to 30 business days in advance. Virginia Premier = Medicaid plans administered through the Department of Medical Assistance Services agreement. Virginia Premier CompleteCare (Medicare-Medicaid Plan), a Commonwealth Coordinated Care Plan: Call us at 1-855-338-6467 to get a printed copy of the directory. 804.380.1306 . Member Services Network Educators Pre-Authorizations Provider Connection Support Provider Relations Quality Improvement Join Our Network Please click here to view and download. 678-510-4590 or 678-510-4600 Press 2 for Claims . Medallion 4.0: 1-800-424-4518. Virginia Medicaid. Box 5028Troy, MI 48007-5028, Behavioral Health ClaimsP.O. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. Department of Medical Assistance Services, DMAS - Department of Medical Assistance Services, Breast & Cervical Cancer Prevention and Treatment Act, Addiction and Recovery Treatment Services, Hospital Presumptive Eligibility Information, Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Behavioral Health Service Utilization and Expenditures, Legislative and Congressional District Reports, Monthly Expenditure Reports of the Medicaid Program, Nursing Facility Value-Based Purchasing Program, CHIP State Plan and Waiver-Related Documents, | | s -w-po-ny | | | Deutsch | | Tagalog | Franais | | Igbo asusu | | | Espaol | | Ting Vit | Yorb. Southeastrans offers public transportation vouchers and fuel/gas reimbursement as an alternative. Forms to allow you to contact the Department of Medical Assistance Services. Find a VA location Main VA phone numbers MyVA411 main information line. Our Medicaid and Medicare Advantage (HMO D-SNP) health plans cover doctor visits, emergency care, hospital stays and prescriptions. In an effort to increase the ease of doing business with us, we have provided links below to connect you with our resources. Available to Medicare Beneficiaries who meet the requirements for long-term care eligibility. Delta Dental is comprised of 39 member companies offering dental coverage in all 50 states, Puerto Rico and other U.S. territories, with a local presence in communities across the country. There are several ways to help your Medicaid members prepare for the Public Health Emergency (PHE) Unwinding. Virginia Medicaid Provider Enrollment Phone Number. For Deaf or Hard of Hearing customers, please dial 711. Topic / Issue Contact Name / Number Virginia Medicaid Contact Information . Virginia. The portal is free of charge for all participating providers. Qualified transportation providers are invited to contract with Southeastrans in areas where there is a need for transportation resources. Transportation is available to services in the members home community. Medical Provider Service Representatives757-552-7474 or 1-800-229-88228 a.m. to 5 p.m. Monday through FridayFax: 757-552-7316ProviderRelations@sentara.com, Behavioral Health Provider Service Representatives757-552-7174 or 1-800-648-84208 a.m. to 6 p.m. Monday through FridayFax: 757-552-7499ProviderRelations@sentara.com. Need to contact us about Optima Health Community Care? Find the phone number to call for the help you need. . Be a United States citizen or be lawfully present in the U.S. HOME | VIRGINIA | MEMBERS | TRANSPORTATION PROVIDERS | FACILITIES. Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, and Sentara Health Plans, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Optima Health Plan. Southeastrans will review applications to determine if there is a need for new transportation providers in the region where you are located. Click here to get help you need related to your iPads or using the Provider Portal. Notice of Privacy Practices (NPP). 757-552-7085 or 1-877-865-9075Fax: 757-552-7114, Medical Care Management Preauthorizations757-552-7540 or 1-800-229-5522Fax: 757-552-7429 or 1-877-800-2839, Behavioral Health Preauthorizations757-552-7174 or 1-800-648-8420, option 2Fax: 757-552-7176 or 1-877-800-2839, Medical Provider Customer Service: 757-552-7474Behavioral Health Provider Customer Service: 1-800-648-84208 a.m. to 5 p.m. Monday through FridayProviderconnectionsupport@sentara.com. Box 1440Troy, MI 48099-1440. | | Ting Vit | | Franais | | | | 23219 For Medicaid Enrollment Web: www.coverva.org Tel: 1-833-5CALLVA TDD: 1-888-221-1590. . Governor Northam recently announced the creation of a Task Force on Primary Care in partnership with the Virginia Center for Health Innovation (VCHI) and Secretary of Health and Human Resources Daniel Carey. Deutsch | Tagalog | | Srpsko-hrvatski | | | Our fax number is 804-819-5174. It will not be kept, reviewed, or forwarded to the plan. Virginia Provider Relations Manager. Virginia. Emails are responded to within three business days. Contact the Medicaid office in your county/region to apply for Medicaid or to find out more about Non-Emergency Transportation. Virginia Premier's Provider Portal, is a safe and secure tool that gives providers quick and easy access to: The valid OMB control number for this information collection is 0938-1378. All rights reserved. You can choose to sign up to have your premium payments deducted from your bank account or your monthly Social Security (or Railroad Retirement Board) benefit. 800-698-2411. Credentialing and joining our network - 1-800-353-1232 (TTY: 711) Special programs and other phone numbers Availity help - registration questions, help with user name/password - 1-800-282-4548 (TTY: 711) EDI QuestionsExisting customers with questions about EDI (the 837 process) should email the EDI Team at editeam@sentara.com. If you have questions for the Claims Department or suggestions on how we can improve our operations, please call us at 800-727-7536, press 4 for Claims. IMPORTANT Do not send this form or any items with your personal information (such as claims, payments, medical records, etc.) For provider enrollment inquiries, contact the Virginia Medicaid Provider Enrollment Helpdesk by phone at 804-270-5105 or 888-829-5373. Your permanent address and phone number; Note: You must complete all items in Section 1. . If you have any questions, please call Customer Care. Optima Preferred Provider Organization (PPO) products are issued and underwritten by Optima Health Insurance Company. All interested transportation providers must complete and submit a Request for Qualifications form and Vehicle List. To contact the Provider Relations department, please email contactmyrep@VirginiaPremier.com. 877-222-8387 Hours: Monday through Friday, All Optima Health plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Sentara Health Plans, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. If you have a claims question, please call please call us at 1-800-727-7536, press 4 for Claims. VA health care VA health benefits hotline. DMAS. Contact your local provider Relations Manager to get detailed information about insurance requirements in your state. to the PRA Reports Clearance Office. You are leaving the PruittHealth Premier website, from October 1st March 31st, 5 days a week from April 1st September 30th. We welcome your feedback and look forward to supporting all your efforts to provide quality care. Important: To join a Medicare Advantage Plan, you must also have both: VisitMedicare.govto learn more about when you can sign up for a plan. |Pilipino| Kreola | Aleman|, Verification of liability insurance coverage, Current Criminal background checks for all drivers, Current drug screens for all owners and drivers, Current motor vehicle driving report for all drivers. Billing Reference Sheets and Claims Submission and Guidelines, Pediatric Obesity Prevention and Treatment Toolkit, Optima Health Community Care Contact Information. Southeastrans understands the challenges of providing transportation services because many of our employees and managers were once transportation providers. Once they process your request to join, theyll contact you. NEMT is a service that is provided to Virginia Medicaid Members who require transportation assistance to Medicaid-billable healthcare services and have no other means of transportation. Tech support is standing by. Customer service representatives are available nationwide to answer questions about your dental insurance, claims submissions, payment procedures . Designed by Elegant Themes | Powered by WordPress. The time required to complete this information is estimated to average 20 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. Any items we get that arent about how to improve this form or its collection burden (outlined in OMB 0938-1378) will be destroyed. VA 23058-5850 . Click to view our protocols and information about testing and/or treatment for COVID-19. Or, call Medicare at1-800-MEDICARE (1-800-633- 4227). Call 855-880-3480 to arrange non-emergency medical transportation services to covered medical services at least five (5) business days (For Medicaid Members) and at least three (3) business days (For Medicare Members), in advance of the appointment date. Virginia Premier values our participating providers and the care they deliver to our members. Virginia Premier has been inspiring healthy living in the communities we serve since 1995. Complete the boxes below to have a plan representative contact you. When you are a member, you also get no-cost extra benefits. For language services, please request while on the line with an agent. *** IMPORTANT *** VIEW OUR COVID-19 INFORMATION HUB, Espaol | | Available to Medicare beneficiaries with a diagnosis of dementia. Here is a general overview: 2) Confirmation of A- or Better Insurance Carrier(s), 3) List of Vehicles covered under Auto policy. Ambulatory, wheelchair, stretcher, and in some programs BLS and ALS transport services are often needed to meet a variety of non-emergency medical transport needs. Optima Health 2022, 4417 Corporation Lane, Virginia Beach, VA 23462-3162. Offering the highest levels of service and consumer ease in the industry. Navigate. Virginia Medicaid Provider Helpline . If a need exists for transportation services in the proposed area, Southeastrans will request additional documentation to determine if your company meets Southeastrans NET Provider contracting requirements. 24-Hour Interactive Voice Response 757-552-7474 or 1-800-229-8822, option 2 Expand All Claims Mailing Addresses EDI and EFT/ERA Information Looking for MDOffice? Note: You must complete all items in Section 1. 800-698-2411 . Optima Health Medicare, Medicaid, and FAMIS programs are administered under agreements with Optima Health and the Centers for Medicare and Medicaid Services (CMS) and the Virginia Department of Medical Assistance Services (DMAS). Search Virginia Premier Prior Authorization (PAL) List. Southeastrans arranges transportation for all Georgia Medicaid Members residing in counties located in the North and Atlanta regions of the State. For managed care assistance, call 800-643-2273 or email ManagedCareHelp@dmas.virginia.gov . Most Common Hospice Denial Codes With Resolutions, NPI Related Error Codes & Resolutions For CMS 1500 (08 05), Top 50 Error Reason Codes With Resolutions, 600 East Broad StreetRichmondVirginia. For language services, please request while on the line with an agent. 23219 For Medicaid Enrollment Web: www.coverva.org Tel: 1-833-5CALLVA TDD: 1-888-221-1590 Copyright 2022 Southeastrans. Call the Southeastrans number that corresponds to your county. 1) Please select your plan: By: Steve M. Date: September 13, 2022. Virginia Premier is dedicated to providing you with great service. Note: If you need an interpreter, call 800-698-2411 and select 0. Atlanta Region Counties: Fulton, . Contact us. Claims Forms Southeastrans provides leadership, support and technology to the transportation providers in our network and fosters a culture of excellence. 600 East Broad Street Richmond Virginia. Phone: 1-855-855-0668 (TTY 711) . We'll connect you with a VA call center agent. 23219 For Medicaid Enrollment .

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