|11/17/2021 9:25 AM|
The claim billing deadline and payment cycles will be adjusted next week due to the holidays.
- WVCHIP claim billing deadline will be Sunday @ 5:00 PM EST. The payment cycle will be moved to Monday night with RAs being released on Wednesday.
- Medicaid claim billing deadline will be Monday @ 5:00 PM EST. The payment cycle will be moved to Tuesday night with RAs being released on Monday the 29th.
Gainwell will be closed on Thursday 11/25 and Friday 11/26.
Please contact Gainwell's Customer Support at (888) 483-0793 if you have any questions.
|8/27/2021 12:11 PM|
WV MEDICAID PROVIDERS: GENERIC APO-VARENICLINE WILL BE COVERED THROUGH 09/30/2021
Because of the current shortage of brand Chantix, WV Medicaid is authorizing pharmacy coverage of generic Apo-Varenicline, with Prior Authorization (PA) required, from now through 09/30/2021.
PLEASE NOTE: WV Medicaid will only pay for claims for Apo-Varenicline submitted for 90 days supplies.
Enrolled pharmacies may dispense Apo-Varenicline for prescriptions for WV Medicaid members if there is not enough product on hand to fill a brand Chantix prescription. However, per guidance from the WV Board of Pharmacy, prescriptions for Apo-Varenicline must be written specifically for either Apo-Varenicline or generic varenicline, if this is the product that is being dispensed.
|6/4/2021 10:49 AM|
Blank Screen Issue Resolution
Below is a resolution to the issue resulting in the blue navigational toolbar tabs returning blank screens. This resolution will resolve this issue for all web browsers (EDGE, Chrome, IE11, Firefox, etc.).
Blank Screen Resolution for All Web Browsers.pdf
Please note if you continue to experience issues with IE11, please follow the below directions to resolve the IE11 compatibility issue.
If you have an questions or concerns with this information please contact the EDI Helpdesk at 1-888-483-0793, option 6 after entering your NPI.
|6/1/2021 10:34 AM|
Google Chrome and Microsoft EDGE web browser versions have been updated to Chrome: 91.04.4472.77 and EDGE: 91.0.864.37. These versions include updates that are not compatible with the Health PAS-OnLine web portal. Users are experiencing blanks screens or display error messages. It is recommended that users utilize Internet Explorer 11, Safari, Firefox, or another web browser until the Chrome/EDGE issue is resolved. Below is a document with instructions on updating IE11 privacy settings to make IE11 compatible. The following Chrome version: 90.0.4430.212 and EDGE version: 90.0.818.66 is still compatible by updating the samesite flags. Below is a document on how to update the flags.
Update Samesite Flags for Chrome and EDGE.pdf
The team is working diligently to resolve these issues and expect
an update very soon. If you have any questions concerning this information or these instructions please contact the EDI Helpdesk at 1-888-483-0793, option 6 after entering your NPI.
|4/26/2021 1:26 PM|
2021 Spring Virtual Workshops Presentations
The 2021 Spring Virtual Workshops presentations are available below. The AM session includes all vendors with their updates. The PM session focused on CSED and SUD programs and the enrollment of direct care workers.
2021 Spring AM Presentation.pdf
2021 Spring PM Presentation.pdf
|4/12/2021 11:20 AM|
Internet Explorer Web Portal Issues
If you are using Internet Explorer (IE) to access and sign into your Health PAS-OnLine web portal account and are experiencing issues with pages displaying blank or features not functioning as expected, it is recommended to use a different web browser other than IE. In the near future, Microsoft will be replacing IE with Microsoft EDGE. Only Internet Explorer 11 is currently supported by Microsoft therefore IE may no longer be compatible with the web portal. Users are most successful with Microsoft EDGE or Google Chrome.
Please contact the EDI Helpdesk (firstname.lastname@example.org) if you have any questions or concerns with this information.
|3/11/2021 4:22 PM|
WV MEDICAID PHARMACY POS CLAIMS FOR VIVITROL AND NALTREXONE 50 MG. TABLETS TO REQUIRE DIAGNOSIS
The Centers for Medicare and Medicaid Services (CMS) has notified the State Medicaid
programs of a new requirement that medications used to treat MAT (Medication Assisted Therapy)
must be identified by diagnosis when submitted to the payer for reimbursement.
WV Medicaid is requesting that you begin including the member’s AUD (Alcohol Use Disorder)
and OUD (Opioid Use Disorder) diagnosis code(s) on prescriptions for Vivitrol and Naltrexone 50 mg. tablets as soon as possible.
The diagnosis code(s) must be for the indication(s) for which the drug is being used.
|3/2/2021 6:04 PM|
In response to the ongoing COVID-19 emergency, WV Providers may submit a claim by paper, electronically and/or by directly keying the claim (DDE) on the web portal for the reimbursement for COVID-19 testing for Uninsured and Private Insured patients. Additional information is available in the below document and in the updated Companion Guides. Please contact a Gainwell Technologies customer service representative at (888) 483-0793 for assistance.
WV COVID-19 Uninsured and Priviate Insured Patient Billing Options.pdf
|11/30/2020 4:20 PM|
Waiver Agencies Healthcare Providers Enrollment
West Virginia Medicaid has extended enrollment to healthcare providers who are now enrolling through Waiver Agencies. A document explaining how agencies enter the data needed to enroll providers is available under Reference Material > Forms. Please review the Waiver Agency Template User Manual and the Bulk Upload Template to assist with the bulk upload process.
|11/16/2020 8:46 AM|
The Health PAS-OnLine web portal received security updates over the weekend. The security questions for new user activation, password reset from the login page and Step 3 of the Trading Partner registration process have been updated from freeform question and answer fields to a more secure predetermined question list with a freeform answer field. Review the attached document for more information.
New Health PAS-OnLine Security Updates.pdf
|10/16/2020 2:23 PM|
Trading Partners are experiencing issues when attempting to access the Health PAS-OnLine web portal from multiple web browsers. The issue is related to multiple browser updates related to cookies. Click the following hyperlink for directions on how to resolve the issue.
Resolve Web Browser Issues To Access Health PAS-OnLine
|7/23/2020 10:46 AM|
The Application for COVID-19 Testing Coverage permits applicants to verbally designate a provider as an authorized representative for purposes of signing and submitting the application. You may not act as an authorized representative unless affirmatively designated by the applicant/patient. Below is the consent form to complete and submit along with the COVID-19 Testing Coverage application.
Application for COVID-19 Testing Coverage.pdf
Appendix C - Consent Form.pdf
To verify the applicant's verbal consent to appoint you as an authorized representative:
1. Ensure that an authorized representative form is filled out in its entirety,
2. Review the entire document verbally while on the telephone with the patient,
3. Write the patient's name on the signature line with a notation that consent was obtained via phone due to COVID-19 precautions,
4. Document the time and date of the call on the form, and
5. Provide the authorized representative consent form with the signed application.
|6/30/2020 2:25 PM|
Reminder - Copay Waiver for Medical/Dental Services
Effective 03/19/2020, The West Virginia Medicaid Program will waive copays for all medical and dental services until further notice. This waiver is related to West Virginia's declared State of Emergency due to the COVID-19 pandemic.
|6/9/2020 8:28 AM|
The West Virginia Medicaid program provides limited health care coverage for the testing and diagnosis of Coronavirus (COVID-19) to the uninsured. This limited coverage may also include outpatient prescription drug treatment for uninsured patients who are experiencing symptoms associated with a possible COVID-19 infection. For more information on how uninsured individuals may apply for coverage, please visit: https://dhhr.wv.gov/bms
|4/2/2020 12:29 PM|
Corona Virus Updates - Revised 03/31/2020
WV MEDICAID MAX SCRIPT DAYS LIMITS CHANGED TO NINETY (90) DAYS FOR NON-CONTROLLED MAINTENANCE MEDICATIONS
Attention WV Medicaid Pharmacy Providers,
In response to the COVID-19 novel coronavirus outbreak, until further notice WV Medicaid has changed the Pharmacy POS Max Script Days limitations policy to allow up to a ninety (90) day supply of Non-Controlled maintenance medications to be dispensed with each fill.
This change does not apply to Non-Controlled NDC?s that currently have a specific Max Script Days limit in place (e.g. 14 days for many short-term oral antibiotics). Those specific Max Rx Days limits will remain in place.
Additionally, this change does not apply to any Controlled Substance NDC's with a DEA Schedule of II, III, IV, or V.
WV MEDICAID COVID RESPONSE: NON-INSURED PATIENTS
In response to the ongoing COVID-19 emergency, WV Medicaid has been authorized to provide Pharmacy POS coverage of a limited number of medications to NON-INSURED patients who are experiencing symptoms associated with a possible COVID-19 infection. The following medications are available under this temporary emergency benefit: *Albuterol 90 mcg inhaler *Guaifenesin *Dextromethorphan *Guaifenesin-dextromethorphan *Acetaminophen
Prescriptions written for these medications may be covered for non-insured patients by using the Medicaid ID number 24000000099.
Prescribers please include on the prescription: "Dx: For symptoms related to a possible COVID-19 infection"
NOTE: In order to cover non-insured patients using the single ID number (24000000099), all automated drug utilization review (DUR) and clinical safety edits have been turned off in our system for any claims using that single ID number. All responsibility for the safety and clinical appropriateness of these medications lies with the prescriber and the filling pharmacist. E-prescribing functionality is still available; however, the patient history will not be accurate for the Medicaid ID listed above.
UPDATE: WV MEDICAID COVERAGE OF PLAQUENIL (HYDROXYCHLOROQUINE) AND CHLOROQUINE
As of 03/27/2020, WV Medicaid has extended the Pharmacy POS coverage of Plaquenil (hydroxychloroquine) and chloroquine to allow for USE WITH A DOCUMENTED POSITIVE TEST RESULT FOR COVID-19, both for WV MEDICAID MEMBERS and NON-INSURED PATIENTS. (Use Medicaid ID number 24000000099 for non-insured patients. DUR and clinical safety edits are turned off for claims for using this single non-insured ID number).
WV Medicaid Members with established history of use of these drugs (60 days of therapy in the past 90 days) will not require Prior Authorization, but all other claims for them will require a review by the WV Medicaid Rational Drug Therapy Program (RDTP), phone number 1-800-847-3859. On-label use requires documentation of diagnosis. Off-label use for COVID-19 requires documentation of a positive test result.
Thank you for all that you are doing during this time. We will let you know of any other changes that may be needed for this situation.
|2/5/2020 1:02 PM|
2020 Spring Provider Workshop ?
Please join us at the 2020 Spring Provider Workshops so you and your staff will be aware of upcoming developments which may impact your practice/organization. The West Virginia Bureau for Medical Services (BMS), the West Virginia Children's Health Insurance Program (WVCHIP), and DXC Technology will be conducting eight workshops throughout the state from March 30 through April 9, 2020. The agenda items will impact a wide variety of providers and topics. Please take a moment to register for the workshop of your choice. Please register using the link below or email one of our Provider Field Representatives at WVProviderFieldRepresentative@molinahealthcare.com
Registration Link: https://www.surveymonkey.com/r/2020SpringProviderWorkshops
|1/27/2020 1:05 PM|
?Effective March 1, 2020 - WV Medicaid will transition how we provide health care for foster children, children adopted from foster care, children in kinship care and children diagnosed with serious emotional disorder (SED).
In order for the below MHP Provider Letter link to work, you must be signed in first. Once logged in, click the link to see the full letter from BMS explaining the details of this upcoming change.
MHP Provider Letter
|7/29/2019 9:31 AM|
WV Health PAS-OnLine Upgrade may require a Browser Update
The WV Health PAS-OnLine web portal will be upgraded this evening Monday, July
29, 2019 after 7:00 PM ET. Your web browser may need to be upgraded to remain compatible with
the Health PAS-OnLine web portal. After the upgrade, only the following browsers will be able to access the web portal. If you have an older browser, you may upgrade by accessing one of the links below:
If you have questions concerning the web portal upgrade or browser requirements, please contact the EDI Helpdesk at (888) 483-0793.
|7/18/2019 12:17 PM|
|6/27/2019 11:22 AM|
?New look for Electronic Health Record
Effective July 1, 2019 the Electronic Health Record functionality known as Care Evolution will no longer be available. The Electronic Health Record tool will utilize a new clinical profile functionality. Clinical Profile provides authorized healthcare providers access to a member's claims and clinical data grouped by relative types (office visits, service history, diagnosis, hospital, transportation, etc.). A new WV Medicaid TPA ? Electronic Health Record User Guide is available to provide assistance with navigating the new Electronic Health Record clinical profile functionality.
|6/20/2019 5:47 PM|
?The Service Coverage Limitations feature of the Member Eligibility Verification tool is INCORRECTLY returning a value of 'SERVICE NOT COVERED' for ALL service codes regardless if the service is covered or not. Please refrain from validating a member's eligibility for a particular procedure code or service code via the web portal until further notice. A new notification will be posted once the feature is displaying correctly. Contact our Customer Support Representatives at 888-483-0793 to verify a member's service coverage limitations. Note, all other eligibility information such as the member's Enrollments, Other Insurance, Copay, etc. is displaying correctly. We apologize for any inconvenience.
|6/6/2019 2:44 PM|
?The Health PAS-OnLine web portal will receive enhancements during the scheduled maintenance window on Saturday June 8, 2019. The new feature available is the 'View Enrolled Providers' option located under the Account Maintenance tab. This feature allows trading partners to view enrollment information for providers and facilities associated to their trading partner account. Click the document below to view more information on this new feature and other enhancements.
Health PAS-OnLine Enhancements.pdf
Contact the EDI Helpdesk by phone: 888-483-0793 or email: email@example.com for assistance with the enhancements.
|5/24/2019 10:23 AM|
Receiver ID/Sender ID Changes
DXC has updated the Receiver ID format for EDI inbound files and the Sender ID format for EDI outbound files.The previous format WV_MMIS_4MOLINA is now WV_MMIS_4_DXCMS. EDI inbound files received with WV_MMIS_4MOLINA will continue to be accepted and processed. ALL outbound acknowledgment and response files (TA1, 999, 824, 271, etc.) will be transmitted with the new Sender ID WV_MMIS_4_DXCMS in the file name and body of the file.
Updated Companion Guides with additional information and examples have been posted on the Health PAS-OnLine web portal under Reference Material. For assistance concerning this change please contact the DXC EDI Helpdesk at 888-483-0793 or email firstname.lastname@example.org.
|5/6/2019 1:32 PM|
?ATTENTION Long Term Care (LTC) Providers, Nursing Home Hospice Providers and their Billing Agencies - UPDATE
New contract rates for LTC claims have been loaded to the claims processing system. Claims pended for rates have been adjudicated.