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Managed Care Network Providers


Information for Managed Care Network Providers about the Medicaid Enterprise System

Providers credentialed in one or more Managed Care Organizations (MCOs) will use the new Provider Services Solution (PRSS) to complete enrollment and maintenance processes. This change is part of the Medicaid Enterprise System (MES) project.

You will be able to update licenses and certifications and submit required attachments through the secure portal. You will also be able to request participation with MCO health plans during the enrollment/revalidation process through the portal.

The new system will also allow Virginia to comply with federal requirements for the 21st Century Cures Act.

If you need to enroll through PRSS, your MCO will send you a schedule in the coming months telling you when to take this action. The Virginia Medicaid agency is working to schedule enrollments for network providers beginning in the summer of 2022 to ensure an efficient process.

If you participate in more than one MCO network, you will receive information and instructions from each managed care health plan.