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Providers told how to enroll, credential and contract for CCMC; plans list claims timing, remittance tools and training
Summary
DMAS and the five Cardinal Care MCOs reviewed steps for provider enrollment through PRSS, MCO credentialing and contract execution, credentialing timelines, claims submission rules and payment cadence. Plans offered provider portals, training calendars and contact pathways.
DMAS reiterated that providers must be enrolled with the state through the Provider Services Solution (PRSS) portal to participate in Cardinal Care. Speakers from Aetna, Anthem, Humana, Centerra (Sentara) and UnitedHealthcare said providers who are already in-network with an MCO do not need to re-enroll for CCMC; providers who wish to join additional MCOs must complete MCO contracting in addition to PRSS enrollment.
Aetna Better Health of Virginia said it uses Availity for claims and authorizations and that most providers can submit…
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