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.
New Portal for Appeals
Virginia Medicaid has a new portal to make it easier for you 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 new 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 if you are a Medicaid member or provider who is not in managed care, you can file directly through the portal. The new DMAS appeals portal allows you to file your appeal, submit documentation and monitor the status of your appeal throughout the process.
- Click here to learn more about the Appeals portal: Watch a video, check out a step-by-step guide, read FAQs and more
- Applicants and members click here to register
- Providers click here to register
- Agencies and DMAS contractors click here to register
- Click here to log in to the Appeals portal
Appeal Forms
We encourage applicants, members, and providers to use the DMAS Appeals Information Management System (AIMS) portal to ensure the most efficient and timely appeal process. Those who do not have easy access to our online portal may use the following forms to file your appeal.
For applicants and members:
- Client Appeal Request Form [pdf]
- Formulario de solicitud de apelación del cliente [pdf]
- Authorized Representative Form [pdf]
- Formulario de representante autorizado [pdf]
- Appeal Withdrawal Request [pdf]
- Solicitud de retiro de apelación [pdf]
For providers:
Contact Information
Virginia Department of Medical Assistance Services
Appeals Division
600 E Broad St
Richmond VA 23219
Main Phone: 804-371-8488
Fax: 804-452-5454
Email: appeals@dmas.virginia.gov