Provider Resources

​

Providers:  Payment Error Rate Measurement (PERM) Review - Reminder to Submit Medical Records

The Centers for Medicare & Medicaid Services (CMS) Payment Error Rate Measurement (PERM) Program for Reporting Year (RY) 2023 is currently reviewing the WV Medicaid and WV Children's Health Insurance program (WVCHIP) to measure imporoper payments in order to maintain the integrity of the Medicaid program.  The Review Contractor (RC) Empower AI is authorized to collect information from providers and to review documentation to ascertain adherence to Medicaid regulations.  Please read here for additional information.

​

Past W​ebinars: Payment Error Rate Measurement (PERM) Webinars

PERM is hosting provider education webinars in the next few weeks.  Please see the schedule below.  The purpose is to offer educational opportunities to Medicaid and Children's Health Insurance Program (CHIP) providers to increase understanding of the specific provider responsibiliti​es during the PERM cycle.  

Following is the list of topics which will be covered:

• ​The PERM process and provider responsibilities during a PERM review
  
• Recent trends, frequent mistakes and best practices
  
• The Electronic Submission of Medical Documentation
  

Schedule of PERM Webinars

Tuesday, April 12, 2022          1:00pm - 2:00pm​  ET.

Wednesday, April 13, 2022     3:00pm - 4:00pm  ET.

Thursday, April 14, 2022         4:00pm - 5:00pm  ET.

To register, please click here.  (Registration closes April 10, 2022 at 5:00pm ET.)​​

​*​NOTE:  All three three webinars will have the same information.  The webinar sessions will be recorded and one of the sessions will be uploaded to the PERM website.  Providers having questions following the webinars or throughout the cycle can send them to the PERM Review Contractor's email address at PERMRC_Providerinquiries@nciinc.com

Looking for more PERM information?  Please click here.

Printable Flyer:  CMS Medicaid and CHIP Providers:  Understanding Your Responsibilities to the Payment Error Rate Measurement (PERM) Program​ 

​​Up-to-Date Addresses

Please remind your patients to make sure their addresses are up-to-date.  Some addresses have been changed by 911, some have been changed because of moving, and other reasons.  Click here for more Information.

​

Telehealth Policy​​

WVCHIP Telehealth Policy

​New Outpatient Therapy Guidelines

Prior Approval/Prior Authorization Forms

Prior Approval for Out of State/Out of Network Services
Precertification for Services

​Prescription Drug Plan​

Current Preferred Drug List 
Express Scripts, Inc. (ESI) Prescription Reimbursement Claim Form​
Prior Approval Request for Prescriptions​
Prior Approval Request Form for ADD Medications
Prior Approval Request Form for Antipsychotics Medications, and Guidelines​

Immunization Resources

​CPT Codes for Immunizations​​​
Immunization Schedule for Ages 0-6 years
Immunization Schedule for Ages 7-18 years

Healthcheck Forms

Healthcheck Provider Manual and Forms

Kindergarten Screening Document

Dental Information

Dental ​Provider Guide​​

Dental Procedure Codes (2021)

Benefit Resources & Reimbursement

Reimbursement for Developmental Screenings

Applied Behavioral Analysis

Policy: Applied Behavior Analysis  (Effective January 2019)

2020 Applied Behavior Analysis (ABA) Allowable Services and Coding Guide Effective July 1, 2020

Minimum Training Standards: Front Line ABA Staff

Pre-Authorization Requests​

Providers who need to submit Prior Authorization requests for ABA services for a WVCHIP member should go to http://wvaso.kepro.com​ to complete your request electronically.  If you experience any problems with your submission, please contact KEPRO at 1-888-571-0262.

​​
​

​