Appeals

Overview

The DMAS Appeals Division is responsible for fairly and impartially providing due process to clients and healthcare providers in full compliance with Virginia law and Medicaid policy.

Virginia Medicaid has a portal to make it easier to file an appeal. If you are enrolled in a managed care program or if you are a provider in a managed care network, you should first work with your designated Managed Care Organization (MCO) to file your appeal. If you want DMAS to review the final MCO internal appeal decision, you can then use the DMAS Appeals Information Management System (AIMS) portal to file for the next level of the appeals process. If you are appealing an eligibility decision, a denial or reduction of services, or have a final decision from your MCO, you can file through the portal. The DMAS appeals portal allows you to file your appeal, submit documentation, and monitor the status of your appeal throughout the process.

• Learn more about the Appeals portal: Watch a short video, check out a step-by-step user guide, read FAQs, and more
• Registration for applicants, members, or their representatives
• Registration for providers
• Registration for agencies and DMAS contractors
• Log in to the Appeals portal