Pharmacy

For Pharmacy forms, please go to our Forms page.

  • Pharmacists as Providers

    According to Senate Bill 1538 (S.B. 1538) requires Virginia Medicaid including Medicaid Managed Care Organizations to reimburse pharmacists for any service provided under a collaborative agreement or statewide protocol.

    Below are the steps for Pharmacists to get credentialed and contracted with Molina Healthcare (MHI). 

    • Pharmacists must first enroll with Virginia Medicaid as a provider through the Provider Services Solution (PRSS) portal at https://virginia.hppcloud.com/.
    • Once enrolled with Virginia Medicaid, send an email to Molina Healthcare Provider Network team at MCCVA-Provider@MolinaHealthcare.com and request to start the contracting and credentialing process with Molina Healthcare (MHI).
    • MHI will send you the required documentation to be completed which also may be accessed at https://www.molinahealthcare.com/-/media/Molina/PublicWebsite/PDF/Providers/va/Forms/VA-ALL-PF-11460-22-VA-Guide-to-Prv-Forms-FINAL_508c.pdf.
      • Provider Information Update Form (Section A only for new providers)
      • W9
      • Attachment D: Services Provided Virginia
      • Americans with Disabilities act (ADA) Form: Virginia
    • You will also need to register with CAQH Proview at https://proview.caqh.org/pr and complete all profile questions to register. Please indicate that you are authorized to access Molina Healthcare data.
    • Please submit the required documentation in #3 to MCCVA-Provider@MolinaHealthcare.com.
    • Once all the required documentation is submitted, MHI will send a provider contract for execution and return to MHI.
    • Once contracting and credentialling approved by MHI, the MHI Provider Relations will outreach you to arrange provider orientation.
    • Pharmacist can submit claims to MHI.



    icon Pharmacist Billing Information  

     

 

 

 

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