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Medallion and FAMIS Virginia Premier Member Resources

Handbook

Virginia Premier helps you access the best possible health care. For more information about our providers and services, please view our detailed member handbook. If you can’t find answers to all of your questions, please contact us. We’re here to help. You can click on one of the links below to view and print the Member Handbook:

(To save any of these documents, Click on the link, click “file,” and then click “save as.”)

•  Filing a Complaint with the Office of Licensure Certification (OLC)

We want to let you know about another way you can file complaints. If you have a complaint about a health care service or facility that is licensed or certified by the Office of Licensure Certification (OLC), you can file a complaint with the OLC. You can file your complaint over the phone or in writing. 

To report a complaint over the phone, call:

Toll Free: 1-800-955-1819 (TTY: 711)
Metro Richmond area: 804-367-2106 (TTY: 711)

When filing a complaint over the phone, be ready to tell the hotline staff:

  1. Your name, telephone number and address. If you want to stay anonymous (nameless) then you can file your report in writing.
  2. The name and address of the medical care entity being reported.
  3. A detailed summary of your concerns.

You can leave a message if you call outside of normal business hours. Messages should be returned the next business day.

To file a complaint in writing, follow these steps:

  1. Go online to vdh.virginia.gov/licensure-and-certification/complaint-unit and select the claims form you need. Depending on your concern, you can use either a Nursing Facility Complaint form or an Other Licensed Entity Complaint form.
  2. Complete the form and include any documents related to your concerns.
  3. Send the written form and related documents using one of the following options.

By US Mail
Complaint Intake
Office of Licensure and Certification
Virginia Department of Health
9960 Mayland Drive, Suite 401
Henrico, VA 23233-1463

By Fax: 1-804-527-4503
By Email: OLC-Complaints@vdh.virginia.gov

Getting Support from the Managed Care Ombudsman

As a Virginia Premier member, you can get help from the Office of the Managed Care Ombudsman if you have questions or need assistance. You can get in touch with them by calling their toll free phone at 1-877-310-6560 (select option 1) or by using one of the following methods.

By US Mail
Office of the Managed Care Ombudsman
Bureau of Insurance
P.O. Box 1157
Richmond, Virginia 23218

By Fax: 804-371-9944
By Emailombudsman@scc.virginia.gov

To learn more, visit https://scc.virginia.gov/boi/omb/index.aspx

Updates

Some important coverage information has changed for our Medallion and FAMIS members. Click on the links below to learn about these changes. Like the members handbooks, you can view, print or save any of these documents:

Quick Links

We’ve put together a list of links to information that is of interest to many of our members. Check out the below pages if you are interested in learning about a specific topic. If you can’t find answers to all of your questions, please contact us. We’re here to help.

  • Online Provider Directory – Search for a provider in our online directory.
  • Provider Directory – Download a copy of the Virginia Premier provider directory for easy access and printing. If you are a Virginia Premier member under the collaboration with Kaiser Permanente, you can view the Virginia Medicaid and FAMIS provider directory on kaiserpermanente.org.
  • Service Area & Enrollment – We have members just like you across the state.  Click here to learn more about our services areas and how to renew your benefits.
  • Member Newsletters – Stay up to date with the latest news from Virginia Premier!
  • Rights & Responsibilities – Our goal is to treat you with respect and dignity.  Learn about your rights and responsibilities as a Virginia Premier member.
  • Transportation – Find out how to schedule transportation to your next appointment with your doctor.  Free for our Medallion II members.
  • Member Safety – Your safety is important to us!  Click here to learn which questions to ask to help prevent medical errors.
  • Forms – Want to change your PCP or request a new ID card?  Use this section to download forms that will get you started.
  • Referrals – Learn about the type of services that may need a request/referral from your doctor.
  • FAQs – Do you have a question about your benefits or our services?  Check out our list of frequently asked questions.
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