• Welcome to
    Health PAS-OnLine
    Medicaid is a State and Federally funded Program for eligible individuals and families
  • Welcome to
    Health PAS-OnLine
    Medicaid is a State and Federally funded Program for eligible individuals and families
  • Welcome to
    Health PAS-OnLine
    Medicaid is a State and Federally funded Program for eligible individuals and families
  • Welcome to
    Health PAS-OnLine
    Medicaid is a State and Federally funded Program for eligible individuals and families
    
1/18/2019 1:18 PM

​The Provider Enrollment Application (PEA) portal will be unavailable Friday 01/18/2018 at 7:00 PM EST until Friday 01/18/2018 at 10:00 PM EST due to maintenance.  We apologize for any inconvenience.  Thank you.

1/10/2019 2:08 PM

The ​WV Medicaid Provider Newsletter for 4th Quarter 2018 is available.

1/7/2019 5:17 PM

Registration is OPEN for the 2019 Spring Provider Workshops.

Please join us at the 2019 Spring Provider Workshops so that you and your staff will be aware of upcoming developments which may impact your practice/organization. Two sessions will be provided: Morning Session - WV Medicaid, WVCHIP, KEPRO, and MCO updates and information; Afternoon Session - Substance Use Disorder Waiver Program updates and information. Click the above link to complete your registration today.  We look forward to seeing you there!

1/7/2019 5:16 PM

DXC Technology's West Virginia Medicaid Call Center is constantly striving to provide the best customer service experience for our provider community.  We would appreciate your feedback on your experience with our call center.  Please complete our Customer Satisfaction Survey by  clicking the available hyperlink. Thank you!

1/4/2019 1:56 PM

FQHC Correspondence Notice

If you are a Federally Qualified Healthcare Center and you received a correspondence dated January 2, 2019 related to reimbursement rates, please disregard, as the information is incorrect. A new, corrected correspondence will be sent in the coming days. We apologize for any inconvenience.

 Welcome

Welcome to Health PAS-OnLine, West Virginia Medicaid and CHIP’s web portal for Members and Providers.

Home Doctor image

This website provides information to West Virginia Medicaid members, providers, trading partners and the public. Users may find helpful website links and documents within our public portal from the menu bar above. Providers and Members are encouraged to click on the appropriate tab above and log into our secure site for individual claims review, enrollment, reports and other helpful tools and information.
Billing updates for Residential Adult Services
1/15/2019 1:12 PM
FQHC Notification
1/10/2019 3:42 PM
2019 ICD-10 Code Announcement
1/8/2019 3:43 PM
Billing updates for HCPCS code A9520
12/21/2018 11:17 AM
2019 Fee Schedule Memo
12/18/2018 3:54 PM
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 Member

Login to the Member Secure Portal to view your
  • Medicaid claims and notifications
  • Medicaid programs and benefits
  • Directory of Providers

 Providers / Trading Partners

Login to the Provider Secure Portal to
  • View Medicaid eligibility and history
  • Submit claims
  • Submit referrals or authorization requests
  • Check document status
  • Resume Provider Enrollment Application
  • Check Provider Enrollment Application Status

 Drug Manufacturers

Login to the Drug Manufacturer Portal

Member Responsibilities

The responsibilities of Medicaid members include, but are not limited to, the following:

  • Notifying providers in a timely manner if unable to keep an appointment.
  • Notifying providers promptly of changes in Medicaid coverage.
  • Notifying providers of any changes in other insurance coverage, such as Medicare or private health insurance.
  • Presenting a valid Medicaid identification card at each visit.
  • Forwarding money or denials received from other insurance payers to their Medicaid providers.
  • Informing their local WV DHHR office of any changes in address, income, etc.
  • Paying providers required co-pays, if applicable.

Member Liability

A provider must accept Medicaid payment as payment in full for covered services. A claim is considered paid in full even when the actual Medicaid payment is zero dollars. Providers are prohibited from imposing any additional charges on the member above the Medicaid allowable reimbursement amount. This does not include Medicaid co-payments, if applicable.

Medicaid members must not be billed, or otherwise held responsible, for:
  • Payments denied for provider error. For example:
    • Claims filed more than one year after date of services
    • Wrongful billing or missing information
  • Billings denied because the provider did not:
    • Follow procedures
    • Obtain prior approval from Medicaid or the managed care provider, if applicable.
    • Notify the member before the service is provided that is not covered by Medicaid.
  • Charges remaining after payments by insurance or Medicaid are made.
  • Fees for missed appointments

Member Responsibilities for Certain Changes

Prior to services being rendered by a provider, the provider must inform or give notice to the member that the provider will not bill Medicaid for the services and the member will be responsible for the charges. Medicaid members, if given prior notice, may be billed for:

  • Services received after Medicaid benefits are exhausted
  • Services not medically necessary that the member elected to receive
  • Services not covered by Medicaid that the member elected to receive
  • Non-emergent services not prior-approved, if applicable
  • Convenience items not required for medical care
  • Services rendered when the member is not eligible
  • Services provided when the member refuses to use other available insurance. The exception to this is the non-methadone medication assisted treatment.

Medicaid Card Information


If you are also enrolled in Managed Care, you will receive a card from that plan, as well. 
  • Medicaid Member Card:  When you qualify as a Medicaid Member, you get a Medicaid card.
  • Only you can use your card.  It is against the law to let anyone else use it.
  • Important Information about your card.   Please be sure to keep it in a safe place so you will have it when you need it. If you lose your card, you may ask for another one by:
    • Calling your case worker at your local Department of Health and Human Resources (DHHR) office, or
    • Calling the DHHR Customer Service Center at 1-877-716-1212.

    If you, or someone in your household, have a medical appointment and you cannot find your Medical Card, you can get a Letter of Creditable Coverage. This letter is only good for the day it is printed. Go to www.wvmmis.com and click "Sign In" at the top of the page. Enter your username and password.  

    If you do not have internet access, your health care provider can confirm your Medicaid eligibility.

    If you have any questions, contact your case worker or the DHHR Customer Service Center at 1-877-716-1212.

You may apply for Medicaid benefits by:
  • Going to the Health Insurance Marketplace at www.Healthcare.gov.
  • Contacting the Federal Marketplace call center at 1-800-318-2596.
  • Going online to www.wvinROADS.org.
  • Visiting your county Department of Health and Human Resources office Monday through Friday 8:30 a.m. to 5:00 p.m., except on state holidays. For your convenience you may call for an appointment. A list of offices can be found at www.dhhr.wv.gov/bcf or you can call the DHHR Change Center at 1-877-716-1212.

Medicaid Member Handbook not created yet.

"Your Guide to Medicaid" and other information about your Medicaid benefits can be found in the Member section of the WV Bureau for Medical Services website at www.dhhr.wv.gov/bms.

11/29/2018 5:36 PM
WV CHIP Premium Invoice Notification

 Help Documents

​ Step-by-step guides are available under Reference Materials/User Guides for Trading Partner registration. Applies to new providers, billing providers, billing agents, and clearinghouses. Providers must register before or after enrollment approval; billing agents, after receiving an Enrollment Case Number from at least one associated billing provider; and clearinghouses, anytime.

Before beginning the enrollment or re-enrollment process, gather all information needed to complete an application.  A detailed description of how to complete each of the enrollment steps and a list of information to have on hand before starting the enrollment application is located in the Provider Enrollment User Guides.  Click the available  hyperlink 'Provider Enrollment User Guides' to access the appropriate guide for assistance submitting an enrollment application for review and approval to bill WV Medicaid.

To access a provider enrollment application, providers must be a registered trading partner on the Health PAS-OnLine web portal.  To register for an account click the available 'Register' hyperlink then select "Provider – Not Yet Enrolled" from the 'Register As' drop down.  Once the trading partner registration is complete, the Provider Enrollment Application (PEA) portal will be available under Account Maintenance: Provider Enrollment.  Full access to the Health PAS-OnLine web portal will be granted once the enrollment application is approved.  Additional information on completing the trading partner registration or completing the enrollment application is available in the user guides located under the Reference Material tab. 

If you have any questions, please contact the Provider Enrollment Unit at (888) 483-0793, option 3, Monday through Friday, between the hours of 7:00 am and 7:00 pm (EST). 

Billing instructions are available here.

  
  
  
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12/28/2018 12:25 PM

DXC Technology's West Virginia Medicaid Call Center is constantly striving to provide the best customer service experience for our provider community.  We would appreciate your feedback on your experience with our call center.  Please complete our Customer Satisfaction Survey by  accessing the link below. Thank you!

DXC Technology Customer Satisfaction Survey

11/29/2018 5:39 PM

A new ​Provider Field Representative Region Map is available.  Please contact the Provider Field Representative group for questions or concerns related to billing, web portal training and/or to request a site visit for assistance.  Contact the group by sending an email to: WVProviderFieldRepresentative@MolinaHealthCare.com and a representative will reach out to you.

We are here to help!

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