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  • Wv Medicaid Provider Eft Agreement Form

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Country Code Provider Identifiers Information Provider Identifiers Provider Federal Tax Identification Number (TIN) or Employer Identification Number (EIN) National Provider Identifier (NPI) Other Identifier(s) Assigning Authority (Required if Identifier is collected) Provider Contact Information Provider Contact Name Telephone Number Telephone Number Extension Email Address P O Box 625 Charleston, WV 25322-0625 Telephone: (888) 483-0793 Fax: (304) 340-2763 Electronic Funds.

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WV Bureau for Medical Services. ​The COVID-19 Continuous Coverage for healthcare benefits is ending in April. Medicaid or WVCHIP will be mailing a renewal letter in the upcoming months. Please update your email, address, and phone number with DHHR if you receive Medicaid or WVCHIP healthcare benefits.

Prior authorization is required for certain Medicaid services and supplies, like home-based care or durable medical equipment (DME).

What is West Virginia Medicaid? The West Virginia Medicaid Program provides a medical card which may be used to receive medical care in the community or in an institutional setting, such as a nursing home. This allows those who may not be able to afford medical care the opportunity to have their health needs addressed.

You must file claims within 1 year from the date you provided services, unless there's a contractual exception. For inpatient claims, the date of service refers to the member's discharge date.

You can contact the Provider Enrollment Department by phone at 1-888-483-0793 Mon-Fri 7 a.m. – 7 p.m., by mail at P.O. Box 625 Charleston, WV 25322-0625, or by email at WVProviderEnrollment@gainwelltechnologies.com for a copy of the Provider Enrollment Criteria Sheet.

Under the expanded eligibility guidelines, adults age 19-64 are eligible for Medicaid with a household income up to 138% of the poverty level. For a single adult in 2023, that amounts to $20,120 in total annual income.

Income & Asset Limits for Eligibility 2023 West Virginia Medicaid Long-Term Care Eligibility for SeniorsType of MedicaidSingleMarried (both spouses applying)Income LimitAsset LimitInstitutional / Nursing Home Medicaid$2,742 / month*$3,000Medicaid Waivers / Home and Community Based Services$2,742 / month$3,0001 more row • 6 Jan 2023

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232