Virginia MedicaidDMAS has a new technology platform called the Medicaid Enterprise System (MES). MES is made up of technology modules specific to all areas of Virginia Medicaid and designed specifically for our Provider network. The MES portal offers many resources for Providers, including comprehensive training, revalidation, access to Medicaid memos and bulletins, provider manuals and more...
A important component of MES is the Provider Services Solution (PRSS) module (also known as the Provider Portal), where providers can login and accomplish many DMAS and Medicaid-related tasks, including enrollment and revalidation.
Provider Enrollment & Revalidation
Start your enrollment process at the Provider Enrollment home page to start/resume a new enrollment/revalidation. Medicaid fee-for-service and Managed Care Organization (MCO) network providers need to enroll in PRSS and revalidate enrollment at least every five years. As one of our valued providers, it is important that you complete your revalidation before the due date to avoid disenrollment. The following information will help you complete this process.
How to Complete Your Revalidation
Providers must submit the revalidation electronically through our Provider Services Solution (PRSS) portal also known as the Provider Portal. PRSS revalidation is when a provider submits a revalidation application for a Provider/National Provider Identifier (NPI) that has an existing enrollment record in PRSS prior to the end of their enrollment period without an enrollment gap. Providers should receive a DMAS notice to begin their revalidation applications at least 90 days before the end of their enrollment period. The notice is sent via email or U.S. Mail depending on the provider's communications preferences recorded in PRSS. Reminder notices are also sent (via email from appshcproductNoReply@gainwelltechnologies.com) at 60 and 30 days prior to the deadline. Providers should add this email to their contacts so that the email is not marked as spam.
Use the New Manage Revalidation Panel in PRSS
There is a new Manage Revalidation panel within the PRSS Provider Portal. This panel displays a list of the in-process revalidation application tracking numbers (ATNs) for the base identification number and any locations for whom that provider may be an Authorized Administrator (AA) for a Primary Account Holder (PAH). This new panel provides information required to access the revalidation application without having to match up numerous notification emails. It also provides a link directly into the Resume/Revalidate Enrollment page to reset the password if needed.
Review the Provider Portal User Guide PRSS-120 located on the MES Provider Training webpage for more information regarding the new Manage Revalidation panel.
Where to Get More Information
You should begin the revalidation application upon receipt of the notice to allow sufficient time for processing. Providers who do not revalidate by the revalidation due date will have their Virginia Medicaid participation status terminated from fee-for-service and MCO networks until the provider successfully enrolls/revalidates in PRSS. Providers can verify their revalidation date via the provider portal. Additional information is provided on MCO Provider Network Resources webpage, and includes links to resources like tutorials and contact information to reach Gainwell with any aspect of the provider's revalidation application. You can also use the MES Provider FAQs for additional help with enrollment and revalidation.