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Submission Requirements

To review EPSDT Personal Care, Private Duty Nursing and Assistive Technology Service Authorization Submission Requirements select the following: Training> Waivers> EPSDT Personal Care, Private Duty Nursing and Assistive Technology Service Authorization Submission Requirements
Posted: 9/11/2018

Service Authorization for EPSDT Personal Care and Attendant Care

Effective September 1, 2018, service authorization requests for Early Periodic Screening, Diagnosis and Treatment (EPSDT) for personal care and attendant care will be reviewed by Keystone Peer Review Organization (KEPRO). The DMAS Medical Support Unit’s (MSU) last day to receive EPSDT personal care requests is August 31, 2018. If you have a case that was pended by the DMAS MSU you must respond back to the DMAS MSU via the provider web portal Atrezzo, by the required time frame noted on the pend request. All other procedures are unchanged. For questions and all other inquiries regarding this change, contact the DMAS Helpline at 1-800-552-8627 or 804-786-6273.
Posted: 8/22/2018

Coming Soon: New Health Coverage for Adults

Beginning January 1, 2019, more adults living in Virginia will have access to quality low cost health coverage. Eligibility is based on income, with a single adult making up to $16,754, or a family of three making up to $28,677, qualifying for coverage. Get more information at www.coverva.org
Posted: 7/6/2018

Alzheimer’s Assisted Living (AAL) Waiver

The Department of Medical Assistance Services (DMAS) will end the Alzheimer’s Assisted Living (AAL) Waiver effective June 30, 2018. KEPRO’s last day to receive continuation of care requests for Alzheimer’s Assisted Living (AAL) Waiver is June 30, 2018. If you have a case that was pended by KEPRO you must respond back to KEPRO via the provider web portal Atrezzo, by the required timeframe noted on the pend request. All case authorizations that end past waiver closure date will be end dated for June 30, 2018. For questions and all other inquiries regarding this change, contact the DMAS Helpline at 1-800-552-8627 or 804-786-6273.
Posted: 6/26/2018

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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


Early and Periodic Screening, Diagnosis, and Treatment ( EPSDT) Services and CCC Plus Waiver- Effective September 1, 2018

Effective for Services beginning on or after September 1, 2018, individuals under the age of 21 in the CCC Plus Waiver must receive personal care, private duty nursing, and assistive technology through EPSDT benefit. Service authorization request for these services are to be submitted to either the respective Managed Care Organization (MCO) for individuals enrolled in managed care or KEPRO through the Atrezzo Connect provider portal for Fee-for-Service. The Managed care plan and KEPRO will utilize EPSDT rules and required documentation in authorizing these services.
Posted: 7/17/2018


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

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