Cardinal Care replaced the old member-facing names. Medallion is not the current brand. The Department of Medical Assistance Services runs Virginia Medicaid. In 2024 the member-facing programs, including managed care, fee-for-service, FAMIS, and Plan First, were brought under the name Cardinal Care. The managed-care organization on the card is still the payer for those members. FAMIS is the children's program and is not a commercial plan.
Cardinal Care replaced the old member-facing names. Medallion is not the current brand.
The Department of Medical Assistance Services runs Virginia Medicaid. In 2024 the member-facing programs, including managed care, fee-for-service, FAMIS, and Plan First, were brought under the name Cardinal Care. The managed-care organization on the card is still the payer for those members. FAMIS is the children's program and is not a commercial plan.
Medicare Part A and Part B for a Virginia practice go to Palmetto GBA, Jurisdiction M, with North Carolina and West Virginia. Maryland and the District of Columbia use Novitas Jurisdiction L. Tennessee and Kentucky's border do not use Jurisdiction M.
Virginia is not a no-fault state. A work injury is billed to the employer's carrier under the Workers' Compensation Commission in Virginia. It is not a Cardinal Care claim.
Virginia billing still fails when a setup says Medallion and the card says Cardinal Care. The managed-care plan name is what goes on the claim. Medicare leaves the state through Palmetto Jurisdiction M, not through the Novitas mailbox used in Maryland.
The member-facing name for Virginia Medicaid, including managed care, fee-for-service, FAMIS, and Plan First. The plan on the card is the payer for managed-care members.
Palmetto GBA, Jurisdiction M. Maryland uses Novitas Jurisdiction L.
The fee is a percentage of net collections. The written rate follows volume, specialty, and how much of the cycle you hand over. There is no setup fee, and the agreement is month to month. The state is not a surcharge. How pricing is set.
