Gainwell Technologies
Member Services (888) 483-0797 or (304) 348-3365 Monday - Friday 8:00 AM - 5:00 PM
Provider Services (888) 483-0793 or (304) 348-3360 Monday - Friday 8:00 AM - 5:00 PM
Pharmacy Help Desk (888) 483-0801 or (304) 348-3370 Monday - Friday 8:00 AM - 5:00 PM, Sunday 12:00 PM - 6:00 PM
Access AVRS using same phone numbers 24/7 or visit the website site at www.wvmmis.com
Paper Claim Form Mailing Addresses
CMS 1500 PO Box 3767 Charleston WV 25337-3767
UB 04 PO Box 3766 Charleston WV 25337-3766
ADA 2006 PO Box 3768 Charleston WV 25337-3768
NCPDB UCF PO Box 3765 Charleston WV 25337-3765
Reversal/Replacement PO Box 3767 Charleston WV 25337-3767
Timely Filing PO Box 2002 Charleston WV 25337-2002
Situational Documentation
Hysterectomy, Sterilization & Pregnancy Termination PO Box 2254 Charleston WV 25328-2254
Bureau for Medical Services
Long-Term Care (304) 352-4241
Third-Party Liability (304) 558-1700
Medicare Buy-In (304) 352-4262
Case Planning Unit (304) 558-1776 Fax
Utilization Management Contractor (UMC)
Long-Term Care
Aged and Disabled Waiver (ADW)
Phone Number 844-723-7811
FAX Number 866-212-5053
General Email WVADWaiver@acentra.com
Additional Information for PAS ADWDocumentation@acentra.com
Submit Re-evaluation MNER requests https://wvltc.kepro.com
Intellectual/Developmental Disabilities Waiver (I/DDW)
Phone Number 866-385-8920 or 304-380-0617
FAX Number 866-521-6882
General Email WVIDDWaiver@acentra.com
Submit additional information for prior authorization requests IDDWDocRequestd@acentra.com
Submit requests for prior authorization https://wvltc.kepro.com
Personal Care
Phone Number 844-723-7811
FAX Number 866-212-5053
General Email WVPersonalCare@acentra.com
Submit requests for prior authorization https://wvltc.kepro.com
Nursing Facility
Phone Number 844-723-7811
FAX Number 844-633-8425
General Email WVPAS@acentra.com
Submit requests https://portal.kepro.com
Medical Services
Phone Number 800-346-8272
FAX Number 866-209-9632
Email wvmedcalservices@acentra.com
Atrezzo Provider Portal https://portal.kepro.com
Acentra Health Provider Website https://wvaso.acentra.com
General Medical Information wvmedicalservices@acentra.com
Medical Form FAX Numbers
Bariatric, Inpatient, Inpatient Rehab Under 21, Organ Transplants 844-633-8426
Outpatient Surgery 844-633-8427
Imaging/Radiology, Laboratory 844-633-8428
Cardiac & Pulmonary Rehab, Durable Medical Equipment, Orthotics and Prosthetics 844-633-8429
Home Health, Hospice, Private Duty Nursing 844-633-8430
Audiology/Speech, Chiropractic, Dental/Orthodontics, Podiatry, Vision, PT/OT 844-633-8431
Carrier List
For Carrier Listing by Name click here
