Immediate Action Needed: Enroll in PRSS Today

As an Optima Health participating provider, you must take immediate action to initiate enrollment through the new PRSS (Provider Services Solution) enrollment wizard.

In April 2022, the Virginia Department of Medical Assistance Services (DMAS) launched a new portal to manage provider enrollment — the Provider Services Solution (PRSS). Medicaid providers will use the PRSS portal, located on the Medicaid Enterprise System (MES) website, to complete enrollment and maintenance processes. This platform will be more efficient and make it easier for you to access the information you need as a Medicaid provider. All Medicaid managed care network providers must enroll through PRSS to satisfy and comply with federal requirements in the 21st Century Cures Act. Those network providers that are currently enrolled as FFS in Medicaid do not have to re-enroll in PRSS.

As an Optima Health participating provider, you must take immediate action to initiate enrollment through the new PRSS (Provider Services Solution) enrollment wizard. All provider types, including hospitals, nursing facilities, residential treatment facilities, and pharmacies must enroll as soon as possible.

Here is what you need to know:

• To enroll, go to “Enroll as a new provider, or check your enrollment status.
• Only one enrollment application is necessary in PRSS, even if you participate with more than one MCO. The application process allows for selection of one or more MCO plans.
• Once approved, providers will need to create a PRSS portal online account in order to revalidate their enrollment, make changes to personal or business information, and check member eligibility. You may be asked to provide evidence of your submission.
• All new MCO-only providers must first enroll with PRSS prior to requesting credentialing with one or more of the managed care health plans.
• You can find helpful training resources on the MES website.

Questions? Contact the PRSS Provider Enrollment Helpline at 804-270-5105 or 1-888-829-5373 or Email: vamedicaidproviderenrollment@gainwelltechnologies.com.