Virginia Medicaid IV-E

Virginia has unique billing rules related to Residential Treatment bills. Logik Solutions created software solutions to address these special rules.


We've met the Challenges of IV-E

If you are accustomed to the specific mental health billing requirements in Virginia, what follows will be familiar—and the solutions are exciting:

  • Capture prior authorizations and bill Virginia Medicaid by the Authorization spans/dates.
  • Hold claims for days and services not authorized, if desired.
  • Room & Board to Virginia Medicaid bill on a UB-04 form or electronic 5010 837I file.
  • Professional charges can bill on a HCFA form or 5010 837P file. Virginia Medicaid permits ancillaries and therapeutic billing in excess of Room and Board Charges.
  • Education services bill on the specialized County Invoice. Produce the Virginia County invoice directly from MEDIK.
  • IV-E patients: For patients in Title IV-E status, we “split” Room and Board fee between Virginia Medicaid and the local County/Governmental agency using the special County invoice.
  • Virginia Medicaid retrospectively changes patient custodial status from Medicaid to County, or full Medicaid or County to IV-E Medicaid. Logik Solutions provides tools to create the retrospective bill to match the custodial change.