Medicaid Virginia
Medicaid Virginia is a Medicaid managed-care plan operating in Virginia. For an ASC, what matters isn't the logo. It's how Medicaid Virginia pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Medicaid Virginia analysis
Tell us where to send it. Our team will prepare an analysis of Medicaid Virginia covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Medicaid Virginia pays
See how Medicaid Virginia reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
Medicaid Virginia's presence spans Virginia. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Medicaid Virginia and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Medicaid Virginia's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Medicaid Virginia up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Medicaid Virginia
- Payer ID
- 10198 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Medicaid Virginia through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Medicaid Virginia members are verified before the date of service, through a clearinghouse using payer ID 10198or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Medicaid Virginia directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Medicaid Virginia the way it pays.
- What is Medicaid Virginia's payer ID?
- Medicaid Virginia's electronic payer ID is 10198. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Medicaid Virginia through a clearinghouse.
- How do ASCs verify eligibility for Medicaid Virginia members?
- Eligibility and benefits for Medicaid Virginia members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 10198) or through the payer's provider portal.
- Does Medicaid Virginia require prior authorization for ASC procedures?
- Prior-authorization requirements for Medicaid Virginia are set per plan and per procedure. Confirm whether an authorization is required with Medicaid Virginia directly before the date of service.
- What type of payer is Medicaid Virginia?
- Medicaid Virginia is a Medicaid managed-care plan operating in Virginia.
- How does Medicaid Virginia compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Medicaid Virginia pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Medicaid Virginia paying my ASC below market?
- Put your own Medicaid Virginia contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.