Cardinal Care Managed Care represents a significant shift in Virginia’s Medicaid system, consolidating previous programs like Medallion 4.0 and CCC Plus. This unified approach aims to streamline healthcare delivery for both providers and Medicaid members. A key aspect of this transition, particularly for beneficiaries enrolled with Aetna Better Health of Virginia, is understanding the Aetna Transition Of Care Program. This article will explore how Cardinal Care and Aetna work together to ensure seamless healthcare transitions for members.
Cardinal Care: Simplifying Medicaid Managed Care in Virginia
The introduction of Cardinal Care is designed to simplify numerous aspects of Virginia Medicaid. For healthcare providers, this means a more straightforward contracting and credentialing process. Instead of navigating multiple systems from Medallion 4.0 and CCC Plus, providers now operate under a single framework for each participating health plan, including Aetna Better Health. This consolidation reduces administrative burden and allows providers to focus more on patient care.
Alt text: Aetna Better Health of Virginia provider portal login page displayed on a laptop screen, emphasizing streamlined access for healthcare professionals.
For Medicaid members, Cardinal Care offers clarity and reduces potential confusion. A unified managed care program minimizes enrollment churn between different systems and fee-for-service models. This stability is crucial for maintaining continuity of care, especially as members’ health needs evolve over time. The Aetna Transition of Care program plays a vital role here, ensuring that members experience smooth transitions as their care requirements change within the Cardinal Care framework.
Continuity and Changes under Cardinal Care
While Cardinal Care introduces a unified system, some essential elements of Virginia Medicaid managed care remain consistent. The same Managed Care Organizations (MCOs) that managed Medallion 4.0 and CCC Plus, including Aetna Better Health of Virginia, continue to partner with the state under Cardinal Care. Providers can still utilize existing systems like the DMAS web-based automated response system (ARS) and the Medicall telephonic system for eligibility verification and managed care enrollment checks.
Alt text: Virginia Medicaid enrollment website homepage displayed on a tablet, highlighting online access for members to manage their Cardinal Care enrollment.
Members retain the ability to select or change their MCO during open enrollment periods through the Cardinal Care Managed Care enrollment website or phone number. This ensures member choice and control within the new system. The Aetna Transition of Care program complements this by focusing on the quality of care transitions within the Aetna Better Health network, ensuring members receive coordinated support during changes in their health journey.
Navigating Service Delivery under Cardinal Care
It’s important for both providers and members to understand how service delivery operates under Cardinal Care. MCOs, including Aetna, are responsible for issuing specific guidance regarding any changes to contracting, claims, and service authorization processes related to Cardinal Care. Providers should look for direct communication from their contracted MCOs for these details.
Regarding Medicaid ID cards, both the older blue-and-white cards and the new Cardinal Care ID cards are valid for claims processing. The new cards reflect the Cardinal Care branding, with MCOs like Aetna issuing updated ID cards that replace previous program logos (Medallion and CCC Plus) with the Cardinal Care logo. For members enrolled in Aetna Better Health, understanding their specific Aetna Transition of Care program benefits and contact points is essential for navigating their healthcare journey within Cardinal Care.
Alt text: Aetna Better Health of Virginia provider contact page on a desktop, emphasizing resources and support available for healthcare providers.
For further information or specific questions, providers can reach out to the Cardinal Care Managed Care contract inbox or directly contact their managed care health plan. Aetna Better Health of Virginia provider services can be contacted at 1-800-279-1878 or through their provider website, offering resources and support related to the Aetna Transition of Care program and general Cardinal Care inquiries. Understanding these resources is crucial for both providers and members to effectively utilize the Cardinal Care system and the Aetna Transition of Care program to its fullest potential.
