Sign into Virginia Premier’s Provider Portal
Virginia Premier is dedicated to providing you with great service. Our secure provider portal is available 24 hours a day to assist you with accessing data quickly and easily. The portal is free of charge for all participating providers.
Virginia Premier’s Provider Portal is a safe and secure tool that gives providers quick and easy access to:
- Submit DME, Home Care, Therapy, Outpatient and emergent Inpatient authorizations
- Verify Member Eligibility
- Check Claim Status and View Details
- Check Authorization Status and View Details
- Create and Submit CMS 1500 claims directly to Virginia Premier through a Claims Entry function
- View PCP Panel listings
One user in your office can obtain an account by registering. That user will be the Office Administrator and can grant access for other users in the office who need access. If you participate with more than one of Virginia Premier’s lines of business, you only need to sign up once in order to view and submit transactions for each line of business.
By logging in to this portal, I affirm that I have read, understand and agree to abide by the following terms and conditions:
I certify I am a health care provider, an employee of a health care provider, a business associate of a health care provider, or an employee of a business associate, and the purpose of my access to any Virginia Premier System is related to the provision or payment of health care services.
With respect to all information viewed or obtained from this site, I agree to comply with all applicable federal and state laws regarding the confidentiality and integrity of health and medical records. This includes full compliance with the Health Insurance Portability and Accountability Act of 1996 (‘HIPAA’), the HITECH Act, and the Virginia Health Records Privacy Act, and applicable regulations to these laws.
I agree to keep confidential all information related to Virginia Premier System business, including, but not limited to, quality and risk management activities as well as other confidential or personal information concerning the medical, personal, or business affairs of Virginia Premier System and its members.
I agree to notify Virginia Premier System immediately in the event that my network access has been compromised in any way and in the event of unauthorized use or disclosure of any information obtained from the Virginia Premier System network.
Providers will be required to review authorization status by utilizing the authorization inquiry functionality in the Provider Portal selection, titled “Medicaid, CCC Plus, Medicare Advantage, DSNP, VCC” (Orange Box). For additional questions please contact the Provider Service Line 1(804) 968-1529
In order to register for an account, if you would like access to all group NPIs/APIs under a single Tax ID, please enter your Tax ID only. If you would like access to a specific group NPI/API instead, please enter it in the field provided.
For expedited registration, please provide a Claim number and the Total Billed Charges on the claim when creating your account.
You will receive an email within 3-5 business days with your username and temporary password.
Please call Technical Support for help with Virginia Premier’s Provider Portal at 1-877-814-9909 or email email@example.com.
Starting January 1, 2023, your Virginia Premier Advantage Elite (HMO D-SNP) pharmacy benefits will be provided through Express Scripts. They are our new pharmacy benefit manager (PBM), replacing Elixir. Also starting January 1, 2023, your vision benefits will be provided
In April 2022, the Virginia Department of Medical Assistance Services (DMAS) launched a new portal to manage provider enrollment -the Provider Services Solution (PRSS). Medicaid providers will utilize the PRSS portal, located on the Medicaid Enterprise System (MES) website, to