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West Virginia Income Maintenance Manual Chapter 24
West Virginia Income Maintenance Manual Page 183 Chapter 24 Long Term Care
APPENDIX E: CONTRACT AGENCY LISTING The following contains contact information for the current contract agencies for LTC coverage groups and Medical necessity questions, Estate Recovery, Annuity and Trusts reporting, and Payment and Billing issues.
Estate Recovery and Annuities and Trusts Health Management Services (HMS) Phone: (304) 342-1604 Fax: (304) 342-1605 Payment and Billing Issues Gainwell Technologies Gainwell Provider Services (888) 483-0793 Gainwell Member Services (888) 483-0797
Contract Agency Listings Utilization Management Contract Agency Medical Necessity Determination TBI Waiver Acentra Health 100 Capitol Street, Suite 600 Charleston, WV 25301 800.346.8272 Phone: (866) 385-8920 Fax: (866) 607-9903 General Email: WVTBIWaiver@acentra.com Acentra Health Phone: (866) 385-8920 Fax: (866) 607-9903 General Email: WVTBIWaiver@acentra.com I/DD Waiver Acentra Health Toll-Free: (866) 385-8920 Phone: (304) 380-0617 Fax: (866) 521-6882 General Email: WVIDDWaiver@acentra.com Psychological Consultation and Assessment, Inc. (PC&A) Phone: (304) 776-7230 Fax: (304) 776-7247 There is no general email box for PC&A for I/DD services. AD Waiver Acentra Health Phone: (844) 723-7811 Fax: (866) 212-5053 Email: WVADWaiver@acentra.com Acentra Health Phone: (844) 723-7811 Fax: (866) 212-5053 Additional Information for PAS: ADWDocumentation@acentra.com