WV Provider Enrollment License/Certification Lapse Policy Version 1.0 West Virginia Provider Enrollment License/Certification Lapse Policy

Transcription

1 West Virginia Provider Enrollment /Certification Lapse Policy Date of Publication: 01/19/2016 Document Version: 1.0

2 /Certification Lapse Policy The Provider /certification Update Reminder Process is as follows: 60 days prior to the license/certification expiration date, an initial reminder letter will be sent to the provider s correspondence address indicating their current license/certification expiration date. If an updated license/certification is not received before the expiration date, the provider will be placed on pay hold. On the license/certification expiration date, providers who have not submitted a copy of their undated license/certification will be placed on pay hold and notified by Molina. If a provider fails to submit a copy of their updated license/certification 30 days after the expiration date, Molina will check listings from the licensing boards. If a provider s license/certification renewal date can be verified through the board listings, the pay hold will be removed. If Molina cannot verify an effective license/certification renewal date via the board listing, the provider will remain on pay hold. A letter will be sent 30 days after the provider s license/certification expiration date to providers who have failed to submit their updated license/certification and for which Molina was not able to verify license/certification renewal through the licensing/certifying boards. The provider will remain on pay hold until the updated license/certification is received and processed by Molina. 60 days after the license/certification expiration date, Molina will make a telephone call to those providers that have not submitted an updated license/certification. Providers who have failed to send an updated license/certification to Molina will remain on pay hold. 90 days after the license/certification expiration date, Molina will determine which providers have not complied and submitted an updated license/certification. Providers who have not submitted an updated license/certification will receive notification of intent to terminate if the updated license/certification is not received within 30 days. If after 121 days from the initial license/certification expiration date Molina has not received the provider s updated license/certification, the provider s claims will be voided from Accounts Payable and the provider will be terminated from West Virginia Medicaid. A letter will be sent to the provider notifying them of the termination. Instructions on how to resubmit claims for payment for services rendered by the provider prior to the expiration date will be included in the letter. All other claims will remain voided and not payable. A listing of voided claims will accompany the letter. Providers may mail or fax a copy of any license/certification renewal information or other credential/certification updates prior to expiration of the current license/certification. This mailing address is Molina Provider Enrollment, P.O. Box 625, Charleston, WV and the fax number is Provider Enrollment (304) All providers who have mailed or faxed their updated license/certification will continue their Medicaid enrollment without interruption. Proprietary and Medicaid Solutions Page 2 of 6

3 WV LICENSING AGENCY Dental Examiners WV Office of Laboratory Services WVOLS Board of Hearing Aid Dealers Examiners of Psychologist LICENSE TITLE (PROVIDER) Level of Anesthesia (Dental Providers) Current Dental Clinical Laboratory Practitioner (Applies to WV Independent Labs only) Hearing Aid Fitter School Psychologist State EXPIRATION DATES June 30 February 1 Renewed from issuance date June 30 Valid for 3 years from issuance date Included in current Lapse Process COMMENTS Confirmed 2/17/14 Contact Person Susan Combs Will accept CLIA Kwanii Brown Confirmed via Social Work Examiners WV Examiners for Speech- Language Pathology Psychologist State d Clinical Social Worker Speech Pathologist Audiologist Valid for 2 years from issuance date Valid for 2 years; expiration date will be last day of year Renewed ; even year Renewed Kathy Confirmed 2/21/14 Amy Polen Patty Nesbitt, Administrative Proprietary and Medicaid Solutions Page 3 of 6

4 LICENSING AGENCY and Audiology Physical Respiratory Care Nursing Registered Nurses Optometry Occupational Therapy Medicine LICENSE TITLE (PROVIDER) Physical Respiratory Included in COMMENTS current Lapse Process Services Manager Summar Steele Nancy Massey, WVBORC Nurse Prac and APRNs can apply for this authority. Must have a collaborative agreement on file with Registered Nurses Confirmed 2/19/14 Pam Via Web Site Nurse Midwife; APRNs (CRNA, CNS, CNM, NP) APRN- Prescriptive Authority (CRNA, CNS, CNM, NP) This IS separate documentation from Nursing Optometrist Occupational EXPIRATION DATES ; even year December 31 December 31 October 31 June 30, odd years June 30 December 31; valid for 2 year Medical Doctor Last name A- L June 30 even years Last Name M-Z Via Web Site Proprietary and Medicaid Solutions Page 4 of 6

5 LICENSING AGENCY Medicine Medicine Osteopathy West Virginia Board of Pharmacy LICENSE TITLE (PROVIDER) Physician Assistant Podiatrist Osteopathic Physician Pharmacist for the Pharmacy EXPIRATION DATES June 30 odd years March 31 odd years June 30 odd years Valid for 2 years; based on issuance date bi on June 30 Expired June 30 Included in current Lapse Process COMMENTS Via Web Site Tammy Michelle Proprietary and Medicaid Solutions Page 5 of 6

6 End of Documentation Proprietary and Medicaid Solutions Page 6 of 6