Mountain Health Trust is not Ohio Medicaid, and the Medicare contractor is not CGS. The Bureau for Medical Services runs West Virginia Medicaid. Mountain Health Trust is the managed-care program, and the plan on the card is the payer. Fee-for-service Medicaid is a separate submission. An Ohio Medicaid plan will not pay a West Virginia member.
Mountain Health Trust is not Ohio Medicaid, and the Medicare contractor is not CGS.
The Bureau for Medical Services runs West Virginia Medicaid. Mountain Health Trust is the managed-care program, and the plan on the card is the payer. Fee-for-service Medicaid is a separate submission. An Ohio Medicaid plan will not pay a West Virginia member.
Medicare Part A and Part B for a West Virginia practice go to Palmetto GBA, Jurisdiction M, with Virginia and North Carolina. Ohio and Kentucky use CGS Jurisdiction 15. Pennsylvania and Maryland use Novitas Jurisdiction L.
West Virginia is not a no-fault state. A work injury is billed to the employer's carrier under Offices of the Insurance Commissioner. It is not billed to the Ohio Bureau of Workers' Compensation unless the injury is an Ohio claim.
West Virginia is surrounded by states that use three different Medicare contractors. The practice address has to be read before the Medicare file is picked. Mountain Health Trust does not follow the member into Ohio.
West Virginia's Medicaid managed-care program. The plan on the card is the payer.
Palmetto GBA, Jurisdiction M. Ohio uses CGS. Pennsylvania uses Novitas.
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.
