Medical Services

In December 2009, KEPRO assumed full responsibility for the utilization management contractor (UMC) functions for all Medicaid medical services requiring prior authorization. KEPRO has customized the CareConnection© software to meet the specific requirements of the West Virginia Medicaid contract, provides training and technical assistance for all stakeholders and continues to utilize WVMI (previous medical UMC) as a subcontractor for clinical review of services for Medicaid members that are Dual Eligible and not participating in Managed Care. The WV AUM Medical CareConnection© Provider Portal accommodates the 25,000+ enrolled West Virginia medical providers who request prior authorization for 200,000 WV Medicaid members.

For Medical Services Provider Manuals and instructions, click here.

For Medical Services Provider Forms & Enrollment information, click here.

For Medical Services Provider Data Submission information and instructions, click here.