CompleteCare Announces New Claims Platform
October 7, 2014
Dear Provider:
Thank you for your continued service to our Members! Virginia Premier CompleteCare will be making several exciting changes in the coming weeks. Prior to the end of the year, we will be moving to a new claims platform for Virginia Premier CompleteCare. On October 6, 2014, we also began using Magellan Healthcare Inc. to assist with behavioral health and substance abuse service authorizations.
How does this affect me?
When we move over to the new platform you will see some changes in the information you receive from us. You will need to register with PaySpan to continue to receive Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) payments from Virginia Premier CompleteCare. Our remits, both electronic and paper, will also change. A sample of the new remittances can be found below.
Magellan Behavioral Health Services
As a reminder, effective October 6, 2014, all behavioral health and substance abuse authorizations should be directed to Magellan Healthcare, Inc. at 1-800-424-4971. Authorization request forms are available on our website (https://www.vapremier.com/providers/completecare-overview/provider-forms-library) for the following outpatient services: Mental Health Skill Building, Psychosocial Rehabilitation and Intensive Community Treatment. These forms should be faxed to Magellan at 1-866-354-8758.
Portal Changes
Virginia Premier CompleteCare will be moving to a new online portal in the next few weeks. Current portal users will receive an email with additional information about how to log into the new portal. The functionality will remain the same – you will still be able to check eligibility, check the status of claims, and create and submit claims.
PaySpan
Virginia Premier CompleteCare will be offering EFT services through PaySpan. In the next few weeks, you will receive a remittance containing information regarding PaySpan and directions to register with PaySpan. If you do not register with PaySpan, you will no longer be able to receive EFT services for Virginia Premier CompleteCare claims. You will see changes in the remittance advice that you receive. You will also receive a paper remittance during our first payment cycle with information about how to sign up with PaySpan. There will also be formatting changes – please be aware that if an adjustment is made to a claim that was submitted to Virginia Premier CompleteCare prior to the platform change, you will receive two remittance advices for that claim – the first will be in the old remittance format, with the negative adjustment, and a second in the new format, with the positive adjustment. Please feel free to contact us if you have any questions about this formatting change.
Below is an example of the new 835 that you will receive if you receive your remittance advice electronically. We have highlighted some of the important field changes:
Here is a sample of the new paper remittance advice you will receive:
If you would like more information about how to register with or access PaySpan, visit the video library on their website at https://www.payspanhealth.com/help/videolibrary/. If you need additional assistance or have questions, please contact PaySpan by either sending an email to providersupport@payspanhealth.com or calling their Provider Services Team by dialing 1-877-331-7154, Option 1. Provider Services Specialists are available to assist Monday through Friday from 8am to 8pm, Eastern Time.
Stay tuned for more updates in the coming weeks! Please check our website, www.vapremier.com, for the most up-to-date information. Also, feel free to reach out to your Contracting Specialist, your Provider Service Representative, or your LTSS Manager with any questions or concerns that you may have. You can reach them at 1-800-727-7536 or by emailing us at vphpnetdev@vapremier.com. As always, we appreciate your continued service to our members.
Sincerely,
Patrick McMahon
VP, Network Development & Contracting