Virginia Premier Health Plan

600 East Broad Street, Ste. 400
Richmond, VA 23220
Member Services: 1(800) 727-7536
Fax: (804) 819-5187
Provider services: (800) 727-7536
Web site: www.vapremier.com

Key Staff
Chief Corporate Officer, VCU Health Systems – Carl Gattuso
Medical Director – Renee Miskimmin, MD
Director of Provider Relations – Patrick McMahon, VP Network Development
Government Relations – Karah Gunther, Dir., Government Relations, VCU

Other Contacts
Grievance/Appeals Procedures – Eric Wilson, Program Integrity Officer
Quality Improvement – Renee Miskimmin, MD, Chief Medical Officer
Pharmacy Benefits – Javier Menendez, Director of Pharmacy

Specialized Health Care Services
Service In-House Contracted
Mental Health X
Pharmacy Benefit Mgmt. X- Envision
Vision Care X- VSP
Disease Mgmt. X
Utilization Mgmt. X

 

Network Providers Under Contract (numbers are combined HMO/PPO)
Network Providers HMO PPO PAR
PCPs Under Contract 2,715 2,715
Physician Specialists Under Contract 10,587 10,587
Hospitals Under Contract 86 86
OB/GYNs 737 737

 

Enrollment (as of March 1, 2016: 187,730)
Medicaid MCO 176,467
FAMIS (SCHIP)MCO 11,263

 

Virginia HMO Service Area:

Counties Accomack, Albemarle, Alleghany, Amelia, Amherst, Appomattox, Augusta, Bath, Bedford, Bland, Botetourt, Brunswick, Buchanan, Buckingham, Campbell, Caroline, Carroll, Charles City, Charlotte, Chesterfield, Clarke, Craig, Cumberland, Dickenson, Dinwiddie, Floyd, Fluvanna, Franklin, Frederick, Giles, Goochland, Grayson, Green, Greensville, Halifax, Hanover, Henrico, Henry, Highland, Isle of Wight, King George, King William, Lee, Louisa, Lunenburg, Mecklenburg, Montgomery, Nelson, New Kent, Northampton, Nottoway, Page,  Patrick, Pittsylvania, Powhatan, Prince Edward, Prince George, Pulaski, Roanoke, Rockbridge, Rockingham, Russell, Scott, Shenandoah, Smyth, Southampton, Spotsylvania, Stafford, Surry, Sussex, Tazewell, Washington, Westmoreland, Wise, Wythe

Cities: Bristol, Buena Vista, Charlottesville, Chesapeake, Colonial Heights, Covington, Danville, Emporia, Franklin, Fredericksburg, Galax, Hampton, Harrisonburg, Hopewell, Lexington, Lynchburg, Martinsville, Newport News, Norfolk, Norton, Petersburg, Portsmouth, Radford, Richmond, Roanoke, Salem, Staunton, Suffolk, Virginia Beach, Waynesboro, Winchester