Cardinal Care is Virginia’s unified Medicaid managed care program, streamlining the previous system of separate programs like Medallion 4.0 and CCC Plus. This comprehensive program aims to simplify healthcare access and management for both Medicaid members and providers. It covers a wide range of services, including long-term care and support, adhering to established screening and coverage criteria.
Understanding Cardinal Care Benefits and Services
Cardinal Care offers the full scope of Medicaid managed care services, maintaining comprehensive care management for individuals with significant health needs. This includes but is not limited to doctor visits, hospital stays, prescription drugs, mental health services, and substance abuse treatment.
Simplifying Healthcare for Providers
One of the key advantages of Cardinal Care for providers is the simplification of administrative processes. With the consolidation of previous programs, providers now navigate a single contract and credentialing process for each participating health plan. This streamlines operations and reduces administrative burden.
Enhancing the Member Experience
Cardinal Care seeks to improve the member experience by reducing confusion and simplifying enrollment. The unified program minimizes enrollment churn between managed care and fee-for-service options, promoting continuity of care as members’ needs change. A single point of contact for managed care services enhances clarity and ease of access.
Continuity and Changes under Cardinal Care
While Cardinal Care introduces significant changes, many aspects of Virginia’s Medicaid managed care remain consistent. The same managed care organizations (MCOs) continue to partner with the program. Providers still utilize existing systems like the DMAS web-based automated response system (ARS), the Medicall telephonic system, and 270/271 eligibility transactions for member verification.
The DMAS enrollment broker supports Cardinal Care, allowing members to choose or change their MCO during open enrollment. This can be done online through the Cardinal Care Managed Care enrollment website or by phone.
Using Medicaid ID Cards with Cardinal Care
Existing blue-and-white Medicaid ID cards remain valid for fee-for-service members, ensuring continued claims processing. While new cards provide updated information, both old and new cards are accepted.
For managed care members, MCOs have issued new ID cards featuring the Cardinal Care logo, replacing previous program names. These new cards clearly indicate the program’s benefits coverage.
Contacting Cardinal Care for More Information
For questions regarding Cardinal Care Managed Care contracts, providers can email the dedicated inbox at [email protected].
Additionally, providers can contact their respective managed care health plans directly for specific inquiries. Contact information for participating MCOs, including Aetna Better Health of Virginia, Anthem HealthKeepers Plus, Molina Healthcare, Optima Health, and UnitedHealthcare, is readily available online and through DMAS resources.
