DD Waiver Claims Processing Issue!

September 08, 2016

We posted last evening (on the Waiver Implemtation Page) that because DBHDS had not completed the data entry of the SIS Level/Tier for the priority individuals (those who are currently in a service with a tiered rate structure) that claims were being denied.  We have received information from DMAS that DBHDS had assigned a staff person to complete this task and that those individuals identified by providers will be processed as soon as possible.

If you have had a claim denied because the Level/Tier was not entered via WaMS in the VaMMIS system or if you know, by examining the Service Authorization Summary in the WaMS system for an individual who is currently in a service with a Tiered rate (Group Home, Supported Living, Community Engagement, Group Day), that the SIS Level/Tier is not present — send the 11 digit Service Authorization numbers without any other identifying information to:

Laura Lupejkis at laura.lupejkis@dbhds.virginia.gov

She is very prompt in her response!