• Welcome to
    Health PAS-OnLine
    Medicaid is a State and Federally funded Program for eligible individuals and families
  • Welcome to
    Health PAS-OnLine
    Medicaid is a State and Federally funded Program for eligible individuals and families
  • Welcome to
    Health PAS-OnLine
    Medicaid is a State and Federally funded Program for eligible individuals and families
  • Welcome to
    Health PAS-OnLine
    Medicaid is a State and Federally funded Program for eligible individuals and families
    
5/21/2018 2:13 PM

​The 2018 Spring Provider Workshop presentations are now available on the web portal under Reference Material - WV Provider Workshops or click the available hyperlink '2018 Spring Workshop Presentations' to quickly access the documents.

5/11/2018 5:38 PM

Web Portal Connection Issues

Users who receive the error 'This page can't be displayed' when logging onto the web portal need to contact their Internet Service Provider (ISP) or IT department to request the following DNS mapping be added:  74.116.10.108     adfsi3.molinahealthcare.com 

As a temporary workaround to resolve the issue until ​your ISP or IT department is able to resolve the issue, the IP address can be updated on your computer's local host folder.  For more information on this process click the following hyperlink: Update Local Host.

5/6/2018 9:52 PM

New Web Portal Features and Enhancements

New features and enhancements have been added to the Health PAS-OnLine web portal.  New features include managing Provider and Billing Agent affiliations.  Enhancements have been made to the Provider Directory and Manage Users areas.  For more information on the changes click the following hyperlink:  Health PAS-OnLine Updates

If you experience issues with web portal functionality, it may be necessary to delete browsing history, cookies and temporary internet files to allow your computer to access these new changes.  Click the following hyperlink for information on how to "Delete Browsing History".

If you need assistance with these new features please contact the EDI Helpdesk by calling 888-483-0793, select option 1 to enter an NPI, then select option 6 to speak with the EDI Helpdesk or send an email to edihelpdesk@molinahealthcare.com.

3/19/2018 10:18 AM

Reminder: Effective April 1, 2017, providers billing WV Medicaid for 340B outpatient drugs should submit modifier UD with the HCPCS drug code to identify drugs purchased at 340B prices.  Medicaid is required to exempt these drug claims from drug rebate invoicing.  Submission of the modifier UD will be used to identify administration of 340B drugs at the claim level.

3/13/2018 5:05 PM

Children Residential and Emergency Child Shelter

Billing changes take effect April 1, 2018.  Click the following link: Children Residential and Emergency Child Shelter for more information concerning billing bundled and non-bundled services effective April 1, 2018.  Click the following link: Children Residential and Emergency Child Shelter Service Grids for a list of bundled and non-bundled service codes per residential level.  If you need assistance with these new billing changes please contact your Provider Field Representative or send an email to: WVProviderFieldRepresentative@MolinaHealthCare.Com

 Welcome

Welcome to Health PAS-OnLine, West Virginia Medicaid and CHIP’s web portal for Members and Providers.

Home Doctor image

This website provides information to West Virginia Medicaid members, providers, trading partners and the public. Users may find helpful website links and documents within our public portal from the menu bar above. Providers and Members are encouraged to click on the appropriate tab above and log into our secure site for individual claims review, enrollment, reports and other helpful tools and information.
Billing Update for CPT 90739
6/14/2018 11:17 AM
Optometry Contract Update
6/13/2018 10:07 AM
LTC Coverage Code
4/23/2018 10:54 AM
Children Residential and Emergency Child Shelter
3/19/2018 10:06 AM
340B Outpatient Drugs, Submit with Modifier UD
3/19/2018 9:59 AM
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 Member

Login to the Member Secure Portal to view your
  • Medicaid claims and notifications
  • Medicaid programs and benefits
  • Directory of Providers

 Providers / Trading Partners

Login to the Provider Secure Portal to
  • View Medicaid eligibility and history
  • Submit claims
  • Submit referrals or authorization requests
  • Check document status
  • Resume Provider Enrollment Application
  • Check Provider Enrollment Application Status

 Drug Manufacturers

Login to the Drug Manufacturer Portal

Member Responsibilities

The responsibilities of Medicaid members include, but are not limited to, the following:

  • Notifying providers in a timely manner if unable to keep an appointment.
  • Notifying providers promptly of changes in Medicaid coverage.
  • Notifying providers of any changes in other insurance coverage, such as Medicare or private health insurance.
  • Presenting a valid Medicaid identification card at each visit.
  • Forwarding money or denials received from other insurance payers to their Medicaid providers.
  • Informing their local WV DHHR office of any changes in address, income, etc.
  • Paying providers required co-pays, if applicable.

Member Liability

A provider must accept Medicaid payment as payment in full for covered services. A claim is considered paid in full even when the actual Medicaid payment is zero dollars. Providers are prohibited from imposing any additional charges on the member above the Medicaid allowable reimbursement amount. This does not include Medicaid co-payments, if applicable.

Medicaid members must not be billed, or otherwise held responsible, for:
  • Payments denied for provider error. For example:
    • Claims filed more than one year after date of services
    • Wrongful billing or missing information
  • Billings denied because the provider did not:
    • Follow procedures
    • Obtain prior approval from Medicaid or the managed care provider, if applicable.
    • Notify the member before the service is provided that is not covered by Medicaid.
  • Charges remaining after payments by insurance or Medicaid are made.
  • Fees for missed appointments

Member Responsibilities for Certain Changes

Prior to services being rendered by a provider, the provider must inform or give notice to the member that the provider will not bill Medicaid for the services and the member will be responsible for the charges. Medicaid members, if given prior notice, may be billed for:

  • Services received after Medicaid benefits are exhausted
  • Services not medically necessary that the member elected to receive
  • Services not covered by Medicaid that the member elected to receive
  • Non-emergent services not prior-approved, if applicable
  • Convenience items not required for medical care
  • Services rendered when the member is not eligible
  • Services provided when the member refuses to use other available insurance. The exception to this is the non-methadone medication assisted treatment.

Medicaid Card Information

  • Medicaid Member Card:  When you qualify as a Medicaid Member, you get a Medicaid card.
  • Only you can use your card.  It is against the law to let anyone else use it.
  • Important Information about your card.   Please be sure to keep it in a safe place so you will have it when you need it. If you lose your card, you may ask for another one by:
    • Calling your case worker at your local Department of Health and Human Resources (DHHR) office, or
    • Calling the DHHR Customer Service Center at 1-877-716-1212.

    If you, or someone in your household, have a medical appointment and you cannot find your Medical Card, you can get a Letter of Creditable Coverage. This letter is only good for the day it is printed. Go to www.wvmmis.com and click "Sign In" at the top of the page. Enter your username and password.  

    If you do not have internet access, your health care provider can confirm your Medicaid eligibility.

    If you have any questions, contact your case worker or the DHHR Customer Service Center at 1-877-716-1212.

Medicaid Card Information


If you are also enrolled in Managed Care, you will receive a card from that plan, as well. 
  • Medicaid Member Card:  When you qualify as a Medicaid Member, you get a Medicaid card.
  • Only you can use your card.  It is against the law to let anyone else use it.
  • Important Information about your card.   Please be sure to keep it in a safe place so you will have it when you need it. If you lose your card, you may ask for another one by:
    • Calling your case worker at your local Department of Health and Human Resources (DHHR) office, or
    • Calling the DHHR Customer Service Center at 1-877-716-1212.

    If you, or someone in your household, have a medical appointment and you cannot find your Medical Card, you can get a Letter of Creditable Coverage. This letter is only good for the day it is printed. Go to www.wvmmis.com and click "Sign In" at the top of the page. Enter your username and password.  

    If you do not have internet access, your health care provider can confirm your Medicaid eligibility.

    If you have any questions, contact your case worker or the DHHR Customer Service Center at 1-877-716-1212.

Visit or call your local Department of Health and Human Resources (DHHR) office to receive a case worker or call the DHHR Customer Service Center at 1-877-716-1212.
You may apply for Medicaid benefits by:
  • Going to the Health Insurance Marketplace at www.Healthcare.gov.
  • Contacting the Federal Marketplace call center at 1-800-318-2596.
  • Going online to www.wvinROADS.org.
  • Visiting your county Department of Health and Human Resources office Monday through Friday 8:30 a.m. to 5:00 p.m., except on state holidays. For your convenience you may call for an appointment. A list of offices can be found at www.dhhr.wv.gov/bcf or you can call the DHHR Change Center at 1-877-716-1212.

**Medicaid Member Handbook not created yet.

Medicaid Member Handbook not created yet.

"Your Guide to Medicaid" and other information about your Medicaid benefits can be found in the Member section of the WV Bureau for Medical Services website at www.dhhr.wv.gov/bms.

3/25/2016 5:40 PM
WV CHIP Premium Invoice Notification

 Help Documents

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Billing instructions are available here.

Before beginning the enrollment or re-enrollment process, gather all information needed to complete an application.  A detailed description of how to complete each of the enrollment steps and a list of information to have on hand before starting the enrollment application is located in the Provider Enrollment User Guides.  Click the available  hyperlink 'Provider Enrollment User Guides' to access the appropriate guide for assistance submitting an enrollment application for review and approval to bill WV Medicaid.

To access a provider enrollment application, providers must be a registered trading partner on the Health PAS-OnLine web portal.  To register for an account click the available 'Register' hyperlink then select "Provider – Not Yet Enrolled" from the 'Register As' drop down.  Once the trading partner registration is complete, the Provider Enrollment Application (PEA) portal will be available under Account Maintenance: Provider Enrollment.  Full access to the Health PAS-OnLine web portal will be granted once the enrollment application is approved.  Additional information on completing the trading partner registration or completing the enrollment application is available in the user guides located under the Reference Material tab. 

If you have any questions, please contact the Provider Enrollment Unit at (888) 483-0793, option 3, Monday through Friday, between the hours of 7:00 am and 7:00 pm (EST). 

​ Step-by-step guides are available under Reference Materials/User Guides for Trading Partner registration. Applies to new providers, billing providers, billing agents, and clearinghouses. Providers must register before or after enrollment approval; billing agents, after receiving an Enrollment Case Number from at least one associated billing provider; and clearinghouses, anytime.

  
  
  
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2/21/2018 12:22 PM

A new ​Provider Field Representative Region Map is available.  Currently our Provider Field Representative assignments are being restructured with the addition of new staff.  Please contact the Provider Field Representative group for questions or concerns related to billing, web portal training and/or to request a site visit for assistance.  Contact the group by sending an email to: WVProviderFieldRepresentative@MolinaHealthCare.com and a representative will reach out to you.

We are here to help!

7/21/2017 4:53 PM

To access a provider enrollment application, providers must first become a registered trading partner on the Health PAS-OnLine web portal.  To register for an account click the available 'Register' hyperlink then select "Provider – Not Yet Enrolled" from the 'Register As' drop down.  The Provider Enrollment Application (PEA) portal will be available under Account Maintenance: Provider Enrollment after the trading partner registration is complete.  Additional information on completing the trading partner registration or completing the enrollment application is available in the user guides located under the Reference Material tab. 

If you have any questions or need additional assistance, contact the Provider Enrollment Unit at (888) 483-0793, option 3, or the EDI Helpdesk at (888) 483-0793, option 4, Monday through Friday, between the hours of 7:00 am and 7:00 pm (EST). 

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