Medicaid Vendors and Contractors

​This page provides a list of current Medicaid vendors and contractors. 

KEPRO (formerly APS Healthcare)- Utilization Management  
Long Term Care​
Aged and Disabled Waiver (ADW)
​Phone Number ​844-723-7811
FAX Number ​866-212-5053
​General Email WVADWaiver@kepro.com
​Additional Information for PAS ADWDocumentation@kepro.com
​Submit Re-eval MNER requests https://wvltc.kepro.com
Intellectual/Developmental Disabilities Waiver (I/DDW)
​Phone Number ​866-385-8920 or 304-380-0617
​FAX Number ​866-521-6882
​General Email WVIDDWaiver@kepro.com
​Submit additional information for prior authorization (PA) requests

IDDWDocRequestd@kepro.com

Submit requests for prior authorization https://wvltc.kepro.com
Personal Care
​Phone Number ​844-723-7811
FAX  Number ​866-212-5053
​General Email WVPersonalCare@kepro.com
​Submit requests for prior authorization https://wvltc.kepro.com
Nursing Facility
​Phone Number ​844-723-7811
​FAX Number ​844-633-8425
​General Email WVPAS@kepro.com
​Submit requests https://c3kepro.com/cms/main
​Medical Services
​Phone Number
​800-346-8272
​FAX Number ​866-209-9632
​Email wvmedcalservices@kepro.com
ORG Managers: C3 Care Connection Enrollment
​AUM Managers: C3 Care Connection Provider Portal
​General Medical Information wvmedicalservices@kepro.com
Medical Form FAX Numbers
​Bariatric, Inpatient, Inpatient Rehab Under 21, Organ Transplants 844-633-8426
​Outpatient Surgery ​844-633-8427
​Imaging/Radiology, Laboratory 844-633-8428
​Cardiac & Pulmonary Rehab, Durable Medical Equipment, Orthotics and Prosthetics ​844-633-8429
​Home Health, Hospice, Private Duty Nursing 844-633-8430
​Audiology/Speech, Chiropractic, Dental/Orthodontics, Podiatry, Vision, PT/OT 844-633-8431

 

 Managed Care Organizations

Aetna Better Health of West Virginia (formerly Coventry Health Care of West Virginia)   800-348-2922

The Health Plan of the Upper Ohio Valley  888-613-8385

UniCare   800-782-0095

West Virginia Family Health  855-412-8466

MAXIMUS - The Medicaid Managed Care Enrollment Broker  800-449-8466

 

Molina Medicaid Solutions

Member Services
​(888) 483-0797 or
(304) 348-3365
Monday - Friday
 8:00 AM - 5:00 PM  
​Provider Services ​(888) 483-0793 or
(304) 348-3360
​Monday - Friday
8:00 AM - 5:00 PM  
Pharmacy Help Desk  ​ ​(888) 483-0801 or
(304) 348-3370
​Monday - Friday
8:00 AM - 5:00 PM  
Sunday
12:00 PM - 6:00 PM
 Access AVRS using same phone numbers 24/7 or visit the website site at www.wvmmis.com

Paper Claim Form Mailing Addresses
​Form ​Address ​City ​State ​ZIP
​CMS 1500 ​PO Box 3767 ​Charleston ​WV ​25337-3767​
​UB 04 ​PO Box 3766 ​Charleston ​​WV ​25337-3766​
​ADA 2006 ​PO Box 3768 ​Charleston ​​WV ​25337-3768​
​NCPDB UCF ​PO Box 3765 ​Charleston ​​WV ​25337-3765​
​Reversal/Replacement ​PO Box 3767 ​Charleston ​​WV ​25337-3767​
​Timely Filing ​PO Box 2002 ​Charleston ​​WV ​25337-2002​
 
Situational Documentation
​Form ​Address City​ State ZIP
Hysterectomy, Sterilization & Pregnancy Termination ​PO Box 2254 ​Charleston ​WV ​25328-2254

 

 Non-Emergency Medical Transportation

 The Bureau for Medical Services recognizes three types of transportation services:

  • Air ambulance;
  • Ground ambulance; and
  • Non-ambulance, non-emergency medical transportation.
Arrangements for non-emergency, non-ambulance transportation of Medicaid members will be made by BMS’ contracted statewide transportation broker, LogistiCare. On September 1, 2018, LogistiCare became the new non-emergency medical transportation (NEMT) manager for West Virginia. LogistiCare is contracted to provide excellent customer service and high-quality, safe, and reliable transportation to your covered services. 
 
For members who use gas mileage reimbursement, a LogistiCare Gas Mileage Reimbursement Trip Log will be included in your welcome letter from LogistiCare. Effective  
September 1, 2018, gas mileage reimbursement will be limited to the nearest medically appropriate and qualified provider not to exceed 125 miles from the member's home 
in-state or within 30 miles of the West Virginia border. When comparable treatment may be obtained at a facility closer to the member's home than the one chosen, mileage 
reimbursed is limited to the distance to the nearest facility. 
 
Ambulance Fee Schedule
 
For more information contact LogistiCare at 1-844-549-8353.
 

 

 

 

 

 

 

 

 

 

 

 

350 Capitol Street | Room 251 | Charleston, WV 25301 | Phone: (304) 558-1700 | Contact Us | Site Map