This page provides a list of current Medicaid vendors and contractors.
KEPRO (formerly APS Healthcare)- Utilization Management
| Aged and Disabled Waiver (ADW) |
|
| Phone Number |
844-723-7811 |
| FAX Number |
866-212-5053 |
| General Email |
WVADWaiver@kepro.com |
| Additional Information for PAS |
ADWDocumentation@kepro.com |
| Submit Re-eval MNER requests |
https://wvltc.kepro.com |
|
|
| Intellectual/Developmental Disabilities Waiver (I/DDW) |
|
| Phone Number |
866-385-8920 or 304-380-0617 |
| FAX Number |
866-521-6882 |
| General Email |
WVIDDWaiver@kepro.com |
| Submit additional information for prior authorization (PA) requests |
IDDWDocRequestd@kepro.com |
| Submit requests for prior authorization |
https://wvltc.kepro.com |
| |
|
| Personal Care |
|
| Phone Number |
844-723-7811 |
| FAX Number |
866-212-5053 |
| General Email |
WVPersonalCare@kepro.com |
| Submit requests for prior authorization |
https://wvltc.kepro.com |
| |
|
| Nursing Facility |
|
| Phone Number |
844-723-7811 |
| FAX Number |
844-633-8425 |
| General Email |
WVPAS@kepro.com |
| Submit requests |
https://c3kepro.com/cms/main |
| Medical Services |
|
| Phone Number |
800-346-8272 |
| FAX Number |
866-209-9632 |
| Email |
wvmedcalservices@kepro.com |
| ORG Managers: C3 Care Connection Enrollment |
|
| AUM Managers: C3 Care Connection Provider Portal |
|
| General Medical Information |
wvmedicalservices@kepro.com |
| Medical Form FAX Numbers |
|
| Bariatric, Inpatient, Inpatient Rehab Under 21, Organ Transplants |
844-633-8426 |
| Outpatient Surgery |
844-633-8427 |
| Imaging/Radiology, Laboratory |
844-633-8428 |
| Cardiac & Pulmonary Rehab, Durable Medical Equipment, Orthotics and Prosthetics |
844-633-8429 |
| Home Health, Hospice, Private Duty Nursing |
844-633-8430 |
| Audiology/Speech, Chiropractic, Dental/Orthodontics, Podiatry, Vision, PT/OT |
844-633-8431 |
Managed Care Organizations
Aetna Better Health of West Virginia (formerly Coventry Health Care of West Virginia) 800-348-2922
The Health Plan of the Upper Ohio Valley 888-613-8385
UniCare 800-782-0095
West Virginia Family Health 855-412-8466
MAXIMUS - The Medicaid Managed Care Enrollment Broker 800-449-8466
Molina Medicaid Solutions
| Member Services |
(888) 483-0797 or
(304) 348-3365 |
Monday - Friday
8:00 AM - 5:00 PM |
| Provider Services |
(888) 483-0793 or
(304) 348-3360 |
Monday - Friday
8:00 AM - 5:00 PM |
| Pharmacy Help Desk |
(888) 483-0801 or
(304) 348-3370 |
Monday - Friday
8:00 AM - 5:00 PM
Sunday
12:00 PM - 6:00 PM |
Access AVRS using same phone numbers 24/7 or visit the website site at
www.wvmmis.comPaper Claim Form Mailing Addresses
| CMS 1500 |
PO Box 3767 |
Charleston |
WV |
25337-3767 |
| UB 04 |
PO Box 3766 |
Charleston |
WV |
25337-3766 |
| ADA 2006 |
PO Box 3768 |
Charleston |
WV |
25337-3768 |
| NCPDB UCF |
PO Box 3765 |
Charleston |
WV |
25337-3765 |
| Reversal/Replacement |
PO Box 3767 |
Charleston |
WV |
25337-3767 |
| Timely Filing |
PO Box 2002 |
Charleston |
WV |
25337-2002 |
Situational Documentation
| Hysterectomy, Sterilization & Pregnancy Termination |
PO Box 2254 |
Charleston |
WV |
25328-2254 |
Non-Emergency Medical Transportation
The Bureau for Medical Services recognizes three types of transportation services:
- Air ambulance;
- Ground ambulance; and
- Non-ambulance, non-emergency medical transportation.
Arrangements for non-emergency, non-ambulance transportation of Medicaid members will be made by BMS’ contracted statewide transportation broker, LogistiCare. On September 1, 2018, LogistiCare became the new non-emergency medical transportation (NEMT) manager for West Virginia. LogistiCare is contracted to provide excellent customer service and high-quality, safe, and reliable transportation to your covered services.
For members who use gas mileage reimbursement, a LogistiCare Gas Mileage Reimbursement Trip Log will be included in your welcome letter from LogistiCare. Effective
September 1, 2018, gas mileage reimbursement will be limited to the nearest medically appropriate and qualified provider not to exceed 125 miles from the member's home
in-state or within 30 miles of the West Virginia border. When comparable treatment may be obtained at a facility closer to the member's home than the one chosen, mileage
reimbursed is limited to the distance to the nearest facility.
Ambulance Fee Schedule
For more information contact LogistiCare at 1-844-549-8353.