PLEASE SEND FORM TO THE DESIGNATED HEALTHCARE PLAN USING THE CONTACT INFORMATION BELOW FOLLOWING THE TIME FRAME REQUIREMENTS ALSO BELOW All MCOs rely on Contract Standards-3 business days or up to 5 business days if additional information is required CONTACT INFORMATION Commonwealth Coordinated Care Phone Number Fax Number Web Portal (CCC) Plus 855-652-8249 855-661-1828 Aetna Better Health of Virginia (877) 434-7578 (for inpatient) (800)901-0020 (for Anthem HealthKeepers Plus (800) 505-1193 (for outpatient) inpatient) (866) 210-1523 Pending/ TBA 2018 Magellan Complete Care of Virginia (800) 424-4524 (844) 348-3719 (BH Inpatient) 1-888-946-1168 Optima Health Community Care (844) 895-3231 (BH Outpatient) (855) 368-1542 United Healthcare (877) 843-4366 (888) 237-3997 Pending/ TBA 4/1/2018 Virginia Premier Health Plan (844) 513-4951 Timeframe Requirements for Submission Services CI/CS (Concurrent) (excluding CI/CS) Aetna 7 business days 48 hrs. Anthem 14 business days 48 hrs. MCC 7 business days 48 hrs. Optima 7 business days 48 hrs. United Healthcare 14 business days 48 hrs. Virginia Premier 14 business days 48 hrs.
PLEASE SEND FORM TO THE DESIGNATED HEALTHCARE PLAN USING THE CONTACT INFORMATION BELOW FOLLOWING THE TIME FRAME REQUIREMENTS ALSO BELOW All MCOs rely on Contract Standards-3 business days or up to 5 business days if additional information is required CONTACT INFORMATION Commonwealth Coordinated Care (CCC) Plus Phone Number Fax Number Web Portal Aetna Better Health of Virginia 855-652-8249 855-661-1828 Anthem HealthKeepers Plus (800)901-0020 (for inpatient) (877) 434-7578 (for inpatient) (800) 505-1193 (for outpatient) Magellan Complete Care of Virginia (800) 424-4524 (866) 210-1523 Pending/ TBA 2018 Optima Health Community Care 1-888-946-1168 (844) 348-3719 (BH Inpatient) (844) 895-3231 (BH Outpatient) United Healthcare (877) 843-4366 (855) 368-1542 Virginia Premier Health Plan (844) 513-4951 (888) 237-3997 Pending/ TBA 4/1/2018 Timeframe Requirements for Submission (Concurrent) Services (excluding CI/CS) CI/CS Aetna 7 business days 48 hrs. Anthem 14 business days 48 hrs. MCC 7 business days 48 hrs. Optima 7 business days 48 hrs. United Healthcare 14 business days 48 hrs. Virginia Premier 14 business days 48 hrs.
vaMEDabaEPSDTinitialAuthReq.docx