Managed Care Network Providers
Information for Providers about Enrollment in the Medicaid Enterprise System (MES)
In April 2022, the Virginia Department of Medical Assistance Services (DMAS) launched a new MES portal to manage provider enrollment – the Provider Services Solution (PRSS). Virginia must comply with mandatory federal 21st Century Cures Act requirements to enroll and periodically revalidate all providers, including managed care organization (MCO) in-network providers, in its PRSS portal. Dentists do not need to enroll in PRSS. Dentists should continue to enroll with the DMAS Dental Benefits Administrator, DentaQuest. For more information, contact DentaQuest Recruitment: 855-873-1283, NetworkDevelopment@dentaquest.com.
The Center for Medicare and Medicaid Services (CMS) is closely monitoring our compliance and MCOs are prohibited from contracting with providers who do not enroll and revalidate as required in PRSS.
Providers can initiate enrollment or revalidation through the DMAS PRSS enrollment site. Go to the menu drop down in the left corner and select the appropriate "Provider Enrollment" link from the menu to submit a new enrollment application or to revalidate.
Once approved, new providers will need to create a PRSS portal online account in order to revalidate their enrollment, make changes to personal or business information, and check member eligibility. In addition to enrolling in PRSS, new providers must also contact the MCO(s) with whom they intend to contract and satisfy the MCOs' contracting and credentialing requirements.
Additional resources are available on the MCO Provider Network Resources webpage, including contact information for each MCO's provider relations offices (for questions about contracting with the MCOs), and contact information for Gainwell, the DMAS PRSS vendor (for questions about the Virginia Medicaid Provider enrollment process).