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.

Data Submission information and instructions

 

Provider Forms & Enrollment

Medical Services - Provider Enrollment Registration

Medical Services Forms and Memos

Provider Manuals and instructions

CareConnection® System Information

Home Health

Private Duty Nursing

Therapeutic Services - Physical & Occupational Therapy ~ Speech & Audiology ~ Cardiac & Pulmonary Rehabilitation ~ Chiropractic

DME - Durable Medical Equipment

Podiatry

Imaging

Dental

Drug Code Changes