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CMHRS Provider Overview Medallion 4.0

CMHRS Provider Overview Medallion 4.0. PROV_0718-CPOM4-100003. Agenda. Plan Summary Authorizations Portal Training Slide (training documents attached separately) CMHRS Services CMHRS Registration and Authorization Forms. Agenda (continued). CMHRS Registration vs. Authorization

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CMHRS Provider Overview Medallion 4.0

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  1. CMHRS Provider OverviewMedallion 4.0 PROV_0718-CPOM4-100003

  2. Agenda • Plan Summary • Authorizations • Portal Training Slide (training documents attached separately) • CMHRS Services • CMHRS Registration and Authorization Forms Provider Overview for Medallion 4.0

  3. Agenda (continued) • CMHRS Registration vs. Authorization • CMHRS Continuity of Care and the Medical Transition Report • CMHRS Claims Submission • A Word of Thanks • Contact Information Provider Overview for Medallion 4.0

  4. Plan Summary Provider Overview for Medallion 4.0

  5. Plan Summary (continued) Provider Overview for Medallion 4.0

  6. Authorizations Provider Overview for Medallion 4.0

  7. Portal Information – Training A separate training session for the Portal will be coming soon. Provider Overview for Medallion 4.0

  8. CMHRS Services January 1, 2018 Provider Overview for Medallion 4.0

  9. CMHRS Registration and Authorization Forms • Use of the Portal is highly encouraged for CMHRS services. • Forms will need to be attached to the portal authorization submissions. • Registration Form • Initial Authorization Form • ABA Behavior Therapy • Day Treatment/PHP • Intensive In Home • Intensive Community Treatment • Mental Health Skill Building • Psychosocial Rehabilitation • Therapeutic Day Treatment for Adolescents/Children • Continued Stay Form Provider Overview for Medallion 4.0

  10. CMHRS Registration vs. Authorization Provider Overview for Medallion 4.0

  11. CMHRS Registration vs. Authorization (continued) Provider Overview for Medallion 4.0

  12. CMHRS Continuity of Care and the Medical Transition Report (MTR) • Health plans must honor a continuity of care period for up to 30 days, which includes honoring all existing service authorizations. • Health plans receive existing service authorizations through the Medical Transition Report (MTR). • For Virginia Premier, new MTR authorization numbers are generated and letters are sent to providers and members. Provider Overview for Medallion 4.0

  13. CMHRS Claims Submission You can submit claims to Virginia Premier via: Paper Claims Electronic Claims Provider Portal Virginia Premier Health Plan Availity: 1-800-282-4548 Submit CMS 1500 P. O. Box 5550 Payer ID: VAPRM Richmond, VA 23220-0550 Relay Health:1-800-527-8133 Change Healthcare:1-866-371-9066 Payer ID: VAPRM Provider Overview for Medallion 4.0

  14. A Word of Thanks We recognize you’re providing a needed service to your community, and we sincerely appreciate what you do. Provider Overview for Medallion 4.0

  15. CMHRS Contact Information Provider Overview for Medallion 4.0

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