Frequently Asked Questions

As a valued member of Virginia Premier’s Medicaid programs, we want to make sure you know where to find important information on your health care plan and what it covers. Important details such as the following can be found under Medicaid and CCC Plus members:

• Quality improvement programs and activities
• Consumer Satisfaction Results
• Search for in-network providers (doctors) covered including their qualifications, office locations, contact information and hours of operations
• Compliance and reporting compliance concerns
• Clinical Practice Guidelines

You can also access your Member Handbook under Medicaid and CCC Plus member resources which includes information related to:

• Your Rights and Responsibilities as a member
• Notice of Privacy Practices and information related to Protected Health Information (PHI)
• Our Affirmative Statement
• Information services for members
• Coordination of health care services
• Covered and non-covered benefits and services information
• How to receive services through your primary doctor and/or specialist
• How to receive care after normal business hours or in case of an emergency
• How to receive care when you are outside of our service area
• How to file a complaint or appeal a denial of service
• Request language translation assistance or receive materials in an alternative format
• Pharmaceutical procedures
• Addiction and recovery treatment services
• Advanced directives

And throughout the year, be on the lookout for information in our Quarterly Member Newsletter that will discuss topics such as:

• Our Population Health Program
• Our Case Management Program and how to make self-referrals
• How we evaluate new technology
• Member Advisory Committee schedule
• Member safety
• Cultural needs and preferences
• Accessibility of services such as appointment time standards
• Our Chronic Care Management Program, formerly known as Disease Management Program
• Coordination of care and transition to other care
• Under/Over utilization results of services available to members

If you would like to have a printed copy of your Medicaid or CCC Plus Member Handbook, or Provider Directory, please call Member Services at 1-800-727-7536 (TTY:711) to ask for a copy to be mailed to you, at no cost.
As always, if you have any questions at all about Virginia Premier, feel free to call Member Services.
It is our pleasure to assist you in meeting your health care needs.

First, contact your local office and let them know about your new address.

It’s also important for Virginia Premier to have your up-to-date contact information. There are two ways to let us know:

• call Member Services at 1-800-727-7536 (TTY: 711), Monday through Friday, 8:00 am to 8:00 pm
• or you can fill out the a change of address form and send it to us

You should get a new member identification card within five (5) business days of the date you requested it. To request a new card, either call us or fill out and submit the ID Card request form.

Remember, you can also use the Member Portal to view, print and order your ID card.

Non-emergency trips need to be set up at least five business days beforehand. Weekends and holidays do not count toward these days.

Call us at 1-855-880-3480 (TTY: 711), Monday – Friday, 6 am – 6 pm to set up a ride. Visit our transportation page for more information.

For a list of providers who participate in our network, go to our Provider Directory search tool. You can also call Member Services at 1-800-727-7536 (TTY: 711) and ask for a print copy of the Provider Directory. It should get to you within five (5) business days after your request.

If you are having an emergency, call 911 right away.

For situations that are not life-threatening or don’t need immediate or complex care, there are other options. If it is during the normal office hours of your Primary Care Physician (PCP), please contact them. The doctor’s name is listed on your Virginia Premier ID card. If your PCP’s office is closed, please contact Virginia Premier’s Nurse Advice Line at 800-256-1982 (TTY: 711). The Nurse Advice Line is available 24 hours a day, seven days a week.

Please contact your local Virginia Department of Social Services. They can provide you with more information.

There are many reasons a prescription could be difficult to fill. Please contact Member Services at 1-800-727-7536 (TTY: 711), and we’ll see how we can help out.

Please contact your local Virginia Department of Social Services. Once they have provided Virginia Premier with your updated information, a new member identification card will be sent to you.

To enroll with Virginia Premier, call the Managed Care Helpline at 1-800-643-2273 (TTY: 1-800-817-6608). Let them know you want to enroll with us.

There are three ways for you to verify your membership status. You can:

• Call Member Services at 1-800-727-7536 (TTY: 711) and use our Interactive Voice Response system
• Call Member Services at 1-800-727-7536 (TTY: 711) and speak to a live representative
• Log on to the Member Portal

Yes, interpreter services are available free of charge. Just call Member Services at 1-800-727-7536 (TTY: 711).