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Traumatic Brain Injury Waiver

The Traumatic Brain Injury (TBI) Waiver Program is a long-term care alternative, which provides services that enable individuals to live at home rather than receiving nursing facility care. The program provides home and community-based services to West Virginia residents who are medically and financially eligible to participate.

Acentra Health, contracted by the Bureau for Medical Services (BMS) is responsible for the day-to-day operations and oversight of the TBI Waiver program. This includes conducting the evaluations that determine medical eligibility for applicants and members, performing provider agency certification and quality/utilization reviews, reviewing requests for prior authorization, providing training and technical assistance to all stakeholders and reviewing requests for prior authorization of TBI Waiver services.

  • TBI-Waiver-umc-provider-manual-final-04 -2024
  • UM Case View Enhancement Demonstration

Atrezzo for Traumatic Brain
Injury (TBI) Waiver 

Beginning May 3, 2021, TBI Waiver Case Management Providers will utilize Atrezzo Next Generation (ANG) to submit Member’s Service Request.  In addition, TBI Waiver Providers and/or PALCO who are assigned to an applicant/ member will be able to access and review applicant/member’s case records including the completed Pre-Admission Screening (PAS), the applicable Rancho scale used to determine initial and reevaluation medical eligibility; medical eligibility determination letters; and Selection and Service Delivery Model (SDM), to name a few. Assigned TBI Waiver Providers and/or PALCO will have the capacity to review and download attached documents and letters from the Member’s Case records for their files.

Atrezzo User Guides
  • Atrezzo Portal MultiFactor Registration and Login Process - New External Users FINAL 4.5.2024
  • Atrezzo Provider Portal UM User Guide FINAL 4.5.2024
  • Atrezzo User Guide Provider Portal (Provider Training Material PDF)
  • Atrezzo WV TBIW Provider Portal User Guide
Provider Training Material
  • How to Add a User - Quick Reference Guide FINAL 1.23.2024
  • How to Add Chrome Browser - Quick Reference Guide FINAL 1.9.2024
  • How to Add Additional Clinical Documentation - Quick Reference Guide FINAL 1.9.2024
  • How to Complete a Saved Request - Quick Reference Guide FINAL 1.9.2024
  • How to Make Revisions to Submitted Requests - Quick Reference Guide
  • How to Reset Password or Unlock Account - Quick Reference Guide FINAL 1.10.2024
  • How to Update User Profile - Quick Reference Guide FINAL 1.10.2024
  • How to View a Determination Letter - Quick Reference Guide FINAL 1.9.2024
  • Atrezzo TBI Waiver PPL Training 04.15.2021
  • Atrezzo TBI Waiver - How to submit a UM Request
Instructional Videos
  • Provider Admin Registration Training Video
  • Provider Admin Add & Manager User Accounts Training Video
  • Atrezzo Provider Portal - Add Documentation and View Determination Letters
  • Atrezzo Provider Portal - How to Complete a Saved Request
  • Atrezzo Provider Portal - How to Submit a New Request
  • Atrezzo Provider Portal - WV TBIW Create Case Wizard Enhancement
  • WV TBIW Atrezzo Provider Portal System Training
Job Aid
  • ANG Job Aid - Creating a New UM Case FINAL 4.5.2024
  • Google Instructions to clear browser history

Consumer Education Goals

Acentra Health staff is available for training and technical assistance and to receive complaints about TBI Waiver service provision.

  • Empowering persons receiving services with information about their rights and responsibilities in communicating with providers and a utilization management contractor
  • Informing people of their rights and responsibilities within the TBI Waiver program
  • Informing people of their role/choice in accessing services through Waiver versus an institution, choice in service delivery model, and service providers
  • Serving as a resource to assist consumers, families, providers and stakeholders with information about alternative resources, advocacy, transitional living homes, food pantries and more.
Resources:
  • Disability Rights of West Virginia
  • Center for Excellence in Disabilities at West Virginia University
  • US Department of Justice and Civil Rights Division Americans with Disabilities Act
  • US Department of Education Individuals with Disabilities Education Act
  • West Virginia Department of Health and Human Resources
  • Brainline
  • National Resource Center for Traumatic Brain Injury
  • Brain Injury Association of America

Provider Education Goals

Acentra Provider Educators and other UMC staff are available for training and technical assistance to TBI Waiver providers.

  • Educating providers about their duties to consumers, families and other stakeholders
  • Completing on-site utilization management and quality outcomes reviews to gather data and provide training/technical assistance to improve the quality of service documentation, services provided and consumer outcomes
  • Assisting providers with proper submission of requests for prior authorization
  • Educating providers about TBI Waiver policy

TBI Waiver Department Contacts

Phone: 866.385.8920
Fax: 866.607.9903
General Email: WVTBIWaiver@acentra.com

Additional Resources

Bureau for Medical Services

350 Capitol Street
Charleston, WV 25301

dashicons-phone (304) 558-1700
dashicons-phone Fax: (304) 558-4398

dashicons-admin-site-alt3 http://www.dhhr.wv.gov/

Fiscal Employer Agent (Personal Options)

PALCO

866-710-0456

West Virginia - PALCO (palcofirst.com)

Claims Processing

Gainwell Technologies

dashicons-phone For Providers: (888) 483-0793
dashicons-phone For Members: (304) 343-3380
dashicons-phone Fax: (304) 348-3380

dashicons-admin-site-alt3 https://www.wvmmis.com/

West Virginia Protective Services

dashicons-phone (800) 352-6513

dashicons-admin-site-alt3 http://www.dhhr.wv.gov/

WV CARES

dashicons-phone (304) 558-2018

dashicons-admin-site-alt3 https://www.wvdhhr.org/

WV CARES Helpful Tips

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Contact Us

1007 Bullitt Street, Suite 200 Charleston, WV 25301

P: (304) 343-9663
Toll Free: (800) 461-0655
F: (866) 473-2354

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