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  • Information About EPSDT from Virginia Premier

    Posted on January 29, 2018 by in Private Practice, State Resources

    Christy Evanko recently spoke with some people at VA Premier, and we worked together to put out the following.  Please email admin@virginiaaba.org if you have any questions or John Strube at Va Premier as indicated below.  John and Andrew were happy to work with us and would like us to bear with them as everything is sorted out.

    Thank you!

    – Although a couple of months ago, it was communicated that VA Premier was not accepting any new providers into their network, the situation has changed and VA Premier is welcoming behavior analysts at this time.  To join their network, go to www.vapremier.com to complete the recruitment request form.  When the drop down box appears, select “Join our network.”  It is on that page that you can find the request form. Providers may also request application and contracting materials directly for John Strube by emailing john.strube@vapremier.com

    – Many providers new to the VA Premier network are being contacted about site visits.  These visits are appropriate if you see clients at your office/clinic.  However, if you are an in-home provider who does not have an office (outside of your home), VABA is working with VA Premier to see if electronic audits would be possible as they are with other MCOs.  Stay tuned!

    – VA Premier is working with Beacon Health Options to provide some Care Management and Utilization Review for defined Behavioral health and ARTS Services. This includes the review of initial request for Authorization and request for continue Authorization once the initial period is ending (you do not need to submit an new request for member you currently have in care with an Auth transferred in from Magellan FFS (DMAS) for those member you will use the continue stay request forms available from DMAS and used by the 6 CCC+ MOC’s.

    – VA Premier has decided to extend all Magellan Authorizations that were set to expire in January of 2018 or later through the 90-day continuity of care period.  At this time their system is not populating with the correct number of units, but as long as you are following the pattern of the original authorization, these units will be covered.  If you have questions about this, please email john.strube@vapremieer.com

    – To submit claims to VA Premier during the Coordination of Care Period and while your application is pending you will need to be set up as an out-of-network provider. You my do this by following the instructions below:

    Provider Process for getting set up as an Out-of-Network Provider during the Coordination of Care period.

    • Provider Submits a paper claim to:

    Virginia Premier Elite Plus

    P.O. Box 4369

    Richmond, VA 23220

    • A W-9 from the Provider should be included with the initial claim.
    • Our Provider Data Team will verify the W-9 information and set the provider up in our system as an Out-of-Network (OON) provider.
    • Once the Provider has been established as an OON provider, the Provider may request access to our Provider Portal for future claims submissions.
      • This may be requested on the Provider Section of our Website:

    https://www.virginiapremier.com/providers/

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