mes project medicaid patient portal

What does Mes stand for in Medicaid?

Medicaid Enterprise System Medicaid Enterprise System (MES) This is an important message for all Medicaid providers. The Virginia Medicaid agency launched a new technology platform on April 4, 2022 as part of the Medicaid Enterprise System (MES) project. A major component of MES is the Provider Services Solution (PRSS) module.

How do I contact the MES provider resource area?

If you have any questions please send them to askmes@dmas.virginia.gov. Welcome to the MES Provider Resource area! This is the new location for Provider information and resources. The information resources on the legacy Medicaid portal are no longer available, but don’t worry - we’ve got you covered!

When will providers need to login to the MES secure portal?

Providers will need to login to the MES secure portal with their new MES credentials after April 4. Don't forget to check our updated Provider FAQ for answers to many popular questions about MES affecting Providers like you. Access the complete and latest Provider Manual set here.

When will Virginia Medicaid's new technology platform launch?

Information about Virginia Medicaid's new technology platform launching in April 2022 as part of the Medicaid Enterprise System (MES) project, including the Provider Services Solution (PRSS) module. Reference site for the Preferred Drug List and Prior Authorization Programs, as well as for information on upcoming changes.

How do I check my Medicaid status in Florida?

Providers can check eligibility for the displaced Florida Medicaid recipients that are being serviced by calling the Florida Medicaid Automated Voice Response System (AVRS) at the following phone number: 1-800-239-7560. number to verify recipient eligibility.

How do I contact Florida Medicaid?

If you have questions, please call 1-877-711-3662, TDD 1-866-467-4970, Monday through Thursday from 8 a.m. to 8 p.m.; Friday from 8 a.m. to 7 p.m. The call is free. Text your enrollment or frequently asked questions to 357662. Click here to create a FL Medicaid Member Portal account and send a secure message.

How do I find my Florida Medicaid ID number?

The front of your Florida Medicaid gold card shows your name and a card identification number called the Card Control Number.

Where do I send my Florida Medicaid claim?

Mail to:Exceptional Claims Processing.P.O. Box 7080.Tallahassee, FL 32314-7080.

How do I check my Medicaid status?

PhoneCall toll-free at 800-252-8263, 2-1-1 or 877-541-7905.Choose English or Spanish.Choose option 2. The person you speak with can help you find out if you have Medicaid or not.

What is the highest income to qualify for Medicaid 2022?

Federal Poverty Level thresholds to qualify for Medicaid The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. For example, in 2022 it is $13,590 for a single adult person, $27,750 for a family of four and $46,630 for a family of eight.

Where can I find my Medicaid ID number?

Medicaid Member Card Information Each Medicaid member will get their own card. The card will have the member's name, Medicaid ID number, and date of birth. The back of the card has helpful contact information and websites for both providers and members.

How do you check if my Medicaid is active online?

Log in to your HealthCare.gov account. Click on your name in the top right and select "My applications & coverage" from the dropdown. Select your completed application under “Your existing applications.” Here you'll see a summary of your coverage.

What is Florida Medicaid called?

Statewide Medicaid Managed CareStatewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services.

What are the income limits for Medicaid 2022 in Florida?

Effective Jan 1, 2022, the applicant's gross monthly income may not exceed $2,523.00 (up from $2,382.00). The applicant may retain $130 per month for personal expenses. However, even having excess income is not necessarily a deal-breaker in terms of Medicaid eligibility.

What is the payer ID for Florida Medicaid?

Providers are required to use the WellCare payer ID 14163 for FFS submissions sent through Connect Center.

What is the income limit for Medicaid in Florida?

Who is eligible for Florida Medicaid?Household Size*Maximum Income Level (Per Year)1$18,0752$24,3533$30,6304$36,9084 more rows

What are the income limits for Medicaid 2022 in Florida?

Effective Jan 1, 2022, the applicant's gross monthly income may not exceed $2,523.00 (up from $2,382.00). The applicant may retain $130 per month for personal expenses. However, even having excess income is not necessarily a deal-breaker in terms of Medicaid eligibility.

What is the income limit for Medicaid in Florida?

Who is eligible for Florida Medicaid?Household Size*Maximum Income Level (Per Year)1$18,0752$24,3533$30,6304$36,9084 more rows

What is Florida Medicaid called?

Statewide Medicaid Managed CareStatewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services.

How do I contact AHCA Florida?

For questions or information, you may contact the Agency for Health Care Administration by feedback form or by phone toll-free at (888) 419-3456.

What is MES in Medicaid?from medicaid.gov

The Medicaid Enterprise System (MES) Contract Status Report contains Medicaid Management Information System (MMIS) and Eligibility and Enrollment (E&E) contract information broken out by Operations and Maintenance (O&M) and Design, Development and Implementation (DDI) activities. The State Officer point of contract information is presented for any additional questions. The MES report is updated quarterly.

Where is the blue button in MES?from vamedicaid.dmas.virginia.gov

If you have been given access to the Secure part of MES, the areas where each module lives, you can use the blue button at the top to login, or just CLICK HERE.

Have a question?from vamedicaid.dmas.virginia.gov

If you have any questions or would like more information... Please contact us!

State-Specific Outcomes - CMS Approved

States requesting enhanced FFP for systems that fulfill state-specific program needs, beyond minimum legal requirements and the baseline of the CMS-required outcomes, should propose State-Specific Outcomes which address the proposed enhancements.

Examples for Health Information Exchanges

We are actively gathering and evaluating outcomes statements crafted by states for this business area.

Where is the blue button in MES?from vamedicaid.dmas.virginia.gov

If you have been given access to the Secure part of MES, the areas where each module lives, you can use the blue button at the top to login, or just CLICK HERE.

Have a question?from vamedicaid.dmas.virginia.gov

If you have any questions or would like more information... Please contact us!

What would improve the current provider enrollment process?

Better integration amongst agencies and health plans as well as a more intuitive provider user interface would improve the current provider enrollment process. An improved provider enrollment process would create a better provider experience, potentially creating benefit across the Medicaid Enterprise via the following: ▪ Wider access to care for Medicaid recipients as more providers will go through the credentialing process when health plans address areas where access to care is lacking ▪ Lower administrative burdens for both the Agency, health plans, and providers by having one credentialing process for the Agency and health plans

What factors affect MES transformation?

Multiple drivers, enablers, and constraints will affect the MES transformation. Discussion of each of these factors follows.

What is OCM in MES?

Organizational Change Management (OCM) will play a critical role not only in transforming the MES project needs within the Agency but in joining the Enterprise (external entities) together toward the common goals. The Agency must be aligned with these changes and key staff must be engaged in how these system changes will modify and improve how processes are carried out, as the new system will create opportunities to streamline many current manual processes.

What is integration services platform?

The Integration Services Platform capabilities provide the highway and network for information needed for subsequent modules and systems to contribute to an excellent experience by all stakeholders, leading to better outcomes across the continuum of care. Specific integration components planned for the Integration Module include: ▪ Enterprise Service Bus (ESB) – connects any request for data or processing to the data or processing service provider ▪ API Gateway – controls access to small APIs that do processing ▪ Publish and Subscribe Alerting – notifies interested systems or parties of information updates relative to a recipient or provider ▪ Managed File Transfer – enables fast and secure transmission of files between systems ▪ Single Sign-on and Secure Authentication – allows users to authenticate to multiple systems using the same user id across systems ▪ Master Person Index and Master Provider Index – processing that identifies records about the same person within a system or found in other systems to link them ▪ Master Data Management – system or rules to evaluate conflicting data about a person or organization to present a best or “golden record” ▪ Service Registry and Service Repository – tracks web services and usage information Based on these design considerations, the Integration Services Platform will enable the Agency to realize benefits in both the nearer and longer-term: Benefits to be Realized Over the Near-Term: ▪ New module integration with the legacy Medicaid Management Information System (MMIS) information and processing ▪ Information access and alert notifications for authorized information consumers at any frequency, including real time. ▪ Improvements in the quality of information ▪ Module to module integration and intercommunication ▪ Role-based security and access control framework for processing within modules and information sharing across modules and systems Benefits to be Realized Over the Long-Term: ▪ A 360-degree view of information about recipients and providers to improve coordination of care

What is EDW in Medicaid?

As the Agency evolves, it will add new modules, partners, and data types. The Agency needs a big-data centric Enterprise Data Warehouse (EDW) to store this growing amount of information while maintaining current Service Level Agreements for responsiveness and accuracy. The EDW will improve the Agency’s capabilities to consolidate, organize, analyze, and report on information in the Medicaid enterprise and provides the foundational structure supporting integration of current data collected by the legacy MMIS system and information provided by new module implementations. The EDW will provide the foundation for decoupling data from proprietary applications. To the extent the system decouples data from applications, the interoperability of the system will grow and reduce the intermodular sequencing dependencies. From an outcome perspective, modularization of capabilities that improve data quality and enabling secure real-time data exchange may benefit from specific sequencing. For example, providing recipient data needed for use by pre-submission data edits and validation may accelerate improvements in data quality. The EDW will also increase the quality of data analysis due to better data quality, better increased processing capacity, and improved response time. The EDW will also be a single source of the truth, improving the consistency of information and analysis provided to stakeholders of the program. The components enabling these analytics within the EDW include the following: ▪ Implementation of an operational data store that improves the quality and consistency of information used by that contributing, using, or analyzing data ▪ A reporting Data Store and Data Warehouse containing real-time information optimized for performance ▪ Data marts optimized to support the different analytic needs of different usage profiles (e.g. tactical operations, compliance reporting, investigation, financial analysis, experience analysis, policy analysist, etc.) within the Agency ▪ Business intelligence and analysis tools optimized for Agency usage profiles New data sources for the EDW may include: ▪ The All Payer Claims Database the Agency is currently implementing to expand consumer information by allowing Floridians to search prices, health care quality, and outcomes for services at Florida hospitals

How to contact PAH for update?from virginiamedicaid.dmas.virginia.gov

If you are the PAH or OrgAdmin and are experiencing issues, please contact the Web Support Helpline at 866-352-0496.

What is the fax number for DMAS?from virginiamedicaid.dmas.virginia.gov

The new fax number is (804) 452-5454.

How to contact DMAS?from virginiamedicaid.dmas.virginia.gov

For more information contact the DMAS Helpline at 1-800-552-8627 or 804-786-6273. To all Medicaid Providers: Provider Appeal Request form now available. There is now a form available on the DMAS website to assist providers in filing an appeal with the DMAS Appeals Division.

Where to fax glucose monitoring?from virginiamedicaid.dmas.virginia.gov

Providers will fax their requests on the Continuous Glucose Monitoring DME Request Form to the DMAS Medical Support Unit at 804-452-5450. The fax request form is available on the DMAS web portal in the Provider Services section.

Does Medicaid cover continuous glucose monitoring?from virginiamedicaid.dmas.virginia.gov

Effective December 15, 2016, DMAS will CLARIFY THAT MEDICAID FEE-FOR-SERVICE COVERAGE of Continuous Glucose Monitoring (CGM) INCLUDES reimbursement for the sensor, transmitter, and receiver used with the invasive monitor. This equipment will be supplied by a Medicaid Durable Medical Equipment (DME) provider and billed as a DME item. Codes to be billed for the DME equipment are:

How to become a medicaid provider in Mississippi?

To enroll as a Mississippi Medicaid provider, you have two submission options: downloading the application and submitting hard copy signature pages/documents. enrolling online and submitting the hard copy signature pages and documentation.

What is Medicaid in Mississippi?

Medicaid is a federal and state program created to provide medical assistance to eligible, low income populations. This service is in place to provide access to quality health care coverage for vulnerable Mississippians.

How long does it take to appeal a Medicaid decision in Mississippi?

Providers are allowed 30 days from the date of the adverse action in which to request an appeal.