General Provider Information
Acentra Health partners with the Department of Medical Assistance Services (DMAS) to implement a Service Authorization program for Medicaid and FAMIS Fee-For-Service enrollees. Under the provisions of federal regulations, the Medical Assistance Program must provide for continuing review and evaluation of care and services paid by Medicaid, including review of utilization of services by Providers and by enrollees.
We offer a variety of resources to assist Providers with submitting Service Authorizations, including (but not limited to) conducting regular Provider virtual trainings on specific services and the use of Atrezzo Next Generation (ANG) to submit authorizations and providing detailed reference materials.
Please Note: when submitting Service Authorizations through ANG, precertification does not guarantee payment. Precertification only identifies medical necessity and does not identify benefits. Submitting false information to gain Service Authorization is prohibited and may result in further legal action to include a referral to the applicable agency, such as the Medicaid Fraud Control Unit, within the Office of the Attorney General. When submitting Service Authorizations to Acentra Health, you are attesting that the information you submit is true and accurate.
Community Advisory Council
Acentra Health, in partnership with the Virginia Department of Medical Assistance Services (DMAS), is seeking community members, Providers, advocates, and healthcare stakeholders to join our Community Advisory Council (C-SAC).
The Council serves as a collaborative forum where council members provide valuable input on healthcare access, quality of care, provider engagement, community outreach initiatives, and service improvements for Virginia Medicaid and FAMIS beneficiaries. Members serve a two-year term and participate in quarterly meetings held virtually.
We are currently looking for additional Council members and encourage interested individuals and organizations to apply.
If you would like to learn more about joining the Community Advisory Council, please email our MCO Liaison at InfoAcentraVADMAS@acentra.com.
Provider MCO External Review Form
If you’re submitting a request for a Managed Care Organization (MCO) External Review, please use the form below and ensure all fields are fully and accurately completed.
When you’re ready to submit, please send the finalized form to dmasexternalreviewcontacts@acentra.com. Once your request has been received by Acentra Health, a Clinical Appeals Specialist will contact you at the email address provided to proceed with your request.
Please Note: failure to complete the form in its entirety may result in delays in processing or follow-up requests for additional information.