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NPI number changes on existing cases

KEPRO is experiencing an influx of requests for changes  in provider's NPI numbers on existing cases. This issue is a result of action taken by DMAS in response to directives in the standards established by Section 6401(a) of the Affordable Care Act (ACA) which requires DMAS to end any NPI number that is inactive or does not match the type that is listed in the national Plan & Provider Enumeration System (NPPES) database. KEPRO is completing requests as timely as possible.
Posted: 5/30/2014

NEW! EFFECTIVE April 1, 2014 Commonwealth Coordinated Care Coverage

Commonwealth Coordinated Care Coverage begins for those who voluntarily enrolled in the Tidewater and Central VA region!!

 

DMAS is pleased to announce the launch of Commonwealth Coordinated Care (CCC), a new initiative to blend and coordinate Medicare and Medicaid services for Virginians receiving both benefits. CCC offers care coordination services and supplemental benefits not currently available to individuals receiving traditional Medicare and Medicaid benefits. Eligible individuals will receive a letter notifying them of their CCC eligibility. For more information on eligibility and CCC services , please visit the CCC webpage at http://www.dmas.virginia.gov/Content_pgs/altc-enrl.aspx . Individuals enrolled in CCC will have all services authorized by the Medicare-Medicaid Plan (MMP) they have chosen: Healthkeepers, Humana, or Virginia Premier. For CCC enrollees, contact the MMP directly for service authorization information.


Posted: 3/28/2014

NEW Changes will be implemented for EDCD waiver and Technology waiver respite authorizations

New changes will be implemented in the Elderly and Disabled with Consumer Direction (EDCD) waiver and the Technology waiver respite service authorization.

  • Respite care service authorization will change from 12 month durations to 24 month durations for requests submitted for all new respite admissions, re-admissions and transfers received by KEPRO beginning March 1, 2014.
  • Requests for respite renewals will continue to be authorized  for 12 months by KEPRO for authorizations that end January 1, 2014 through April 30, 2014.
  • EDCD waiver only- In April 2014, Medicaid member with current respite authorizations that end may 1, 2014 through December 31, 2014 will receive an extended respite authorization. The respite authorization will be automatically extended to 2015 using the members birth month and day. This will be a one time extension to move respite renewals from the fiscal year, June 30th. Future Respite renewal end dates will be calculated based on the requested date which might not coincide with the birth month and date.
  • New respite change in 2015. All respite renewals, new admissions, readmissions, and transfers will be authorized for 24 months. Providers will need to submit a request for services to receive an authorization. This change includes respite services in EDCD waiver an the Technology waiver. There are no automatic renewals.
  • EDCD waiver only- July 1, 2014, providers may choose to align the personal care and respite services.

For more specific information detailing how the respite authorization changes will be implemented, refer to the Medicaid memo dated March 4, 2014 on the Provider Web Portal at: https://virginiamedicaid.dmas.virginia.gov/ under the provider Services tab.

Provider web based training session on the EDCD respite to personal care alignment process is scheduled  on June 3, 2014. click on the Training tab on this site for more information.


Posted: 3/6/2014

Check It - checkmark in checkbox

Service Authorization (Srv Auth) Checklists

Want to avoid hold-ups caused by missing information in Srv Auth requests? Check out the Required Srv Auth Information Checklists. These handy reference lists will help you determine at a glance all the information required for each service type.

Announcements


New Waiver Questionnaires

New Respite Care and Personal Care/Attendant Care questionnaires are now available via Atrezzo Provider Portal case submissions. Completion of the questionnaires are required  to successfully complete your on line case submission.

Utilization of the Atrezzo Provider portal, eliminates the providers need to fax in supporting documentation to KEPRO. Providers have the ability to attach all supporting documents via the Atrezzo Provider Portal


Posted: 6/30/2014


KEPRO is URAC accredited in Health Utilization Management, Disease Management and Case Management. We are also licensed to perform medical reviews in 29 states.

Atrezzo Connect is available for submission of all requests for Virginia Medicaid authorization. LOG IN or REGISTER here...

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