Beginning July 1, 2024, the WVCHIP pharmacy claims will be processed by West Virginia Medicaid's claims processor, Gainwell Technologies. The WVCHIP pharmacy claims with dates of services beginning now through June 30, 2024, will continue to be processed by Express Scripts, the WVCHIP's current pharmacy benefits manager. Providers must be enrolled with West Virginia Medicaid and CHIP before July 1, 2024 to ensure prescriptions are processed and paid. Failing to enroll as a prescribing provider may cause your patients' prescriptions to be denied at the pharmacy.
If you are not already enrolled, please visit https://www.wvmmis.com/ and enroll online as a billing provider or as an "Ordering/Referring/Prescribing(ORP)-Only Provider." The quickest enrollment option is the "ORP-Only" online application process. To prevent interruptions in the member's access to needed prescription medications, prescribers must make sure they are enrolled with West Virginia Medicaid.
For more information, please contact the Bureau for Medical Services (BMS) at 304-558-1700.