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Mental Health Services Claims and Authorization Processes

 


Notice

We ask that all providers work directly with the CCC Plus MCO's directly for issue resolution. If there are issues that are unresolved by the MCO and for questions about the CCC Plus CMHRS services please forward inquiries to DMAS directly at: EnhancedBH@dmas.virginia.gov.

Processes

Medallion 4.0 and CCC Plus Eligibility Tracking Authorization and Claims Process for CMHRS

Using Magellan of Virginia’s Provider Portal:

Forms

CCC Plus and Medallion 4.0 Forms for 2020

Contact Page Update (March 1, 2019): The last page of each form has been revised to reflect that, effective March 18, 2019, Virginia Premier will no longer be using Beacon to complete MLTSS CMHRS/ARTS/BH authorizations. ALL Lines of Businesses will now be completed in-house. The contact information on the last page of each form posted here has now been updated and now reflects the new contact information for Virginia Premier effective March 18, 2019. Continue using existing contact information for Virginia Premier until then. No other form content or MCO Contact information has been changed on these forms.

Contact Page Update (October 14, 2020): The fax numbers for Optima have been updated and can be found below in the document titled "MCO Authorization Contact Information Rev. 10.14.2020." Due to the frequency of changes made to the MCO Contact Information, the "MCO Authorization Contact Information" document will now just be a stand alone document and will no longer be added to the end of each of the authorization request forms. Questions? Please direct them to EnhancedBH@dmas.virginia.gov.



Community Mental Health and Rehabilitation Services Education and Outreach

To find details on all upcoming trainings, please refer to: Magellan of Virginia - Training Resources
Information regarding upcoming trainings will be posted to the DMAS and Magellan of Virginia websites. Recorded trainings will also be posted to both websites. Additional online training resources will be announced once the effective dates are finalized.

 


Magellan - Behavioral Health Service Authorizations

Magellan of Virginia (BHSA) Providers are encouraged to contact Magellan with questions about provider enrollment, provider contracts, covered behavioral health services, service authorizations, Magellan provider handbook, claims, grievances and complaints at: Contact Magellan

 


Licensing / Credentialing / Registration Resources

Registration information for Qualified Mental Health Professionals (QMHPs) is located on the Board of Counseling Website - Qualified Mental Health Professionals

Registration information for Peer Recovery Specialists (PRS) is located on the Board of Counseling Website - Peer Recovery Specialists

Contact Virginia Department of Behavioral Health and Developmental Services (DBHDS)
DBHDS Office of Licensing
DBHDS Office of Human Rights
Virginia Department of Health Professions


Transportation Resources

For transportation information, visit: http://transportation.dmas.virginia.gov or http://www.logisticare.com