West Virginia Medicaid

The Health Plan is one of four managed care organizations approved by the Bureau for Medical Services (BMS) to provide services to West Virginia Medicaid recipients. Medical and behavioral health services are provided to enrollees in the following Medicaid programs:

  • Mountain Health Trust
  • WV Health Bridge
  • SSI

The Health Plan's Provider Manual contains comprehensive information related to best practices for the care of this population.

Prescription Benefits

As of July 1, 2017, pharmacy services for WV Medicaid managed care organization (MCO) members will be administered by the traditional fee-for-service pharmacy program. All prescriptions should be billed with the information below:

BIN 610164
PCN DRWVPROD

Questions regarding claims processing should be directed to the Medicaid’s Fiscal Agent’s POS Pharmacy Help Desk at 1.888.483.0801. The vendor specification document can be found at www.wvmmis.com for further information regarding claims processing.

Dental Benefits

Dental providers should contact SKYGEN at 1.888.983.4690 or skygenusa.com regarding contracting, billing procedures, and benefits.