Prior Authorization Information

This page contains announcements, forms, links and contact information related to WVMI's prior authorization services conducted on behalf of the West Virginia Bureau for Medical Services. Scroll down the page for complete iinformation or click on a link to jump directly to that portion of the page.

Announcements
PA Forms
Training Resources
Links and Logins
Contact Information

News and Announcements

APS CareConnection® Update

5/11/2012

Important Informaton for Radiology and Imaging Procedures

2/1/2012

Speech Therapy and Audiology CareConnections Information Available

1/13/2012

Prior Auth Retrospective Review Submission Time Requirement Change

12/28/2011

PT/OT Providers: DDS Implementation Schedule Modified

12/12/2011

Important Information for PT/OT Providers

12/2/2011

REMINDER INPATIENT SERVICES IMPLEMENTATION for APS Medical CareConnection® DDE System is OCTOBER 31, 2011

10/31/2011

WV C3 Provider Portal Manual Available

10/27/2011

Training available for APS Medical CareConnection® DDE System

10/24/2011

Implementation Go-Live for APS Medical CareConnection® DDE System

10/21/2011

View all news and announcements

Return to the Top of the Page

Prior Authorization Request Forms

Document name Sort

Modified

Acute Care

12/1/2011 8:12:22 AM

APS CareConnection Audiology Prior Authorization Form

4/4/2012 4:03:50 PM

APS CareConnection Speech Prior Authorization Form

4/4/2012 4:04:09 PM

Chiropractic

10/3/2011 4:01:06 PM

Dental

10/3/2011 3:59:14 PM

Durable Medical Equipment

10/3/2011 4:01:27 PM

Home Glucose Monitor

10/3/2011 4:02:18 PM

Imaging

10/3/2011 3:59:44 PM

Incontinence Guidelines

4/17/2012 9:03:32 AM

Infant Apnea Monitor

10/3/2011 4:01:52 PM

Medical C3 PT OT Data Collection Forms

5/7/2012 2:17:42 PM

Medical Inpatient Data Collection Forms

4/4/2012 4:04:49 PM

Orthotics and Prosthetics

10/3/2011 4:00:49 PM

Outpatient Surgery

10/3/2011 3:59:29 PM

PDN Program Instructions

2/13/2012 1:44:50 PM

1 2

Return to the Top of the Page

Training Resources

Document name Sort

Modified

Appeals and Reconsideration Options

11/29/2011 9:40:27 AM

CareConnection Overview Enrollment Guide

1/13/2012 3:22:11 PM

Dental FAQs

10/3/2011 4:27:10 PM

Dental Workshop 2011

10/3/2011 4:21:01 PM

Dental Workshop 2011 (APS)

10/3/2011 4:22:07 PM

Instructions to get your Computer Compatible with APS CareConnection®

5/11/2012 4:51:57 PM

Searching for Determinations

12/1/2011 10:28:34 AM

Searching for Determinations Cheat Sheet

5/11/2012 4:51:36 PM

Tips for Remitting an Authorization

12/1/2011 10:29:22 AM

Using Smart Sheets

10/3/2011 4:27:52 PM

Utilization Management System Presentation

10/3/2011 4:23:06 PM

Utilization Management System Presentation FAQ

10/3/2011 4:26:12 PM

West Virginia C3 Provider Portal Manual

10/27/2011 10:24:24 PM

Return to the Top of the Page

Links and Logins

Direct Data Entry (DDE)
Access to SmartSheets
BMS Provider Manuals
Molina Medicaid Services and billing instructions
APS HealthCare Provider Information, including online submission of Prior Authorization requests

Contact Information & Business Hours

WVMI Medicaid Review Department

3001 Chesterfield Avenue
Charleston, WV 25304

1-800-982-6334 or 304-346-9167

Option 1: Preadmission review for inpatient hospital admissions & inpatient surgery
Option 2: PAS Review: Nursing Home
Option 3: PAS Aged & Disabled Waiver Services
Option 4: Case Management
Option 5: Dental, Chiropractic, Speech, Physical Therapy, Occupational Therapy, Speech, Orthotics & Prosthetic
Option 6: Imaging

1-800-296-9849(for Outpatient Surgery and DME)

Option 1: All other review areas other than outpatient surgery or DME
Option 2: Outpatient Surgery
Option 3: DME

Molina/Unisys

888-483-0797 or 304-348-3365

WVMI Business Hours

Our offices are open Monday through Friday, 8:00 am to 5:00 pm. A recording system will receive calls when the WVMI offices are closed. We will respond to recorded messages before the close of the next business day.

Return to the Top of the Page