Group Number VPis an important distinction enabling Sentara Health Plans to administer the provider agreements for benefits and claims payments. Submit all Group Number VP claims to Payer ID VAPRM. Registration for PaySpan is required. To register, contact by email at [email protected] or call 1-877-331-7154, option 1.Request an enrollment kit. Schedule an appointment. Call a Licensed Plan Advisor at 1-855-434-3267 (TTY: 711) Updated: September 30, 2023. Sentara Medicare HMO members have access to an extensive network of doctors. Find out if … Medicaid Eligibility for Adults. Adults may be eligible if you: are a Virginia resident, age 19 to 64. are a United States citizen or lawfully-residing immigrant. are not eligible or covered by Medicare. you are medically complex. meet the income requirements based on your household size. You may be eligible for a Dual Special Needs Plan (D-SNP ... All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans and the Centers for Medicare and Medicaid Services (CMS). Medicaid and FAMIS products are administered under an agreement …A formulary is a list of covered drugs selected by Sentara Medicare in consultation with a team of health care providers, which represents the prescription therapies believed to be …If you need answers to other questions or need to ask about a specific plan and benefits please call member services from 8 a.m. to 6 p.m. Monday through Friday at the phone number listed on the back of your member ID card. If you are not a member and need information about enrolling, call 757-552-7401. TTY lines for the hearing impaired are 711.Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ...That makes Anthem and Sentara health plans direct competitors for some of the same customers. Anthem argued that it gives the health system an added incentive to terminate Anthem’s coverage. When that type of disruption occurs, the Department of Medical Assistance Services allows Medicaid members to switch health plans outside …As an Integrated Delivery Network (IDN) the change deepens the alignment between Sentara’s healthcare services and health plans. Sentara Health Plans will begin introducing the brand to the market this fall. In Virginia, all health plan members will receive Sentara Health Plans ID Cards around January 1, 2024.Sentara Health Plans offers health insurance coverage to over 875,000 members in Virginia and North Carolina. It has a network of over 35,000 providers and employs clinical and non-clinical staff for member support …Optima Health Code of Compliance. PDF, 143 KB Last Updated: 03/28/2023. PDF, 143 KB Last Updated: 03/28/2023. Access important Compliance documents.Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...As an Integrated Delivery Network (IDN) the change deepens the alignment between Sentara’s healthcare services and health plans. Sentara Health Plans will begin introducing the brand to the market this fall. In Virginia, all health plan members will receive Sentara Health Plans ID Cards around January 1, 2024.Access your plan, find care, pay your bill, and get discounts and cost estimates with Sentara Health Plans. Learn about COVID-19 resources, wellness programs, and … Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ... Sentara Health Plans offers affordable and quality health coverage for individuals and families in Virginia. Choose from Direct or Standard plans, with essential health …Sentara Health Plans is here to help you get back on track with your preventive care, immunizations, and disease management as safely as possible. Emergency Travel Assistance. Sentara Health Plans offers a value-added service called Emergency Travel Assistance. These fully paid, global-emergency medical and travel services are provided … Whether you are seeking coverage for yourself or helping someone else, we are here to answer your questions about our added benefits and services. We can help in other languages. Optima Health Community Care. Toll-free: 1-888-512-3171 (TTY: 711) Monday through Friday, 8 a.m. to 8 p.m. EST/EDT. Medical Benefit Oncology Drugs - Medicaid Coverage (Sentara Community Plan) - Not Managed by Carelon - Referred Back to Sentara Health Plans PDF , 127 KB Last Updated : 01/30/2024 PDF , 127 KB Last Updated : 01/30/2024Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Authorization for Use or Disclosure of Medical Information (Designated Representative) PDF, 115 KB Last Updated: 12/21/2023. PDF, 115 KB Last Updated: 12/21/2023. Find important documents and forms relating to your Sentara Family Care and Sentara Health Plans Community Care Medicaid plan.Sentara Health Plans Member Portal Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ... Sign In. The resources listed here are intended for providers associated with Sentara Community Plan, the plan formerly known as Virginia Premier. If you forgot your username or need help with your password, call 1-877-814-9909 or email [email protected]. Activate. Setting up MDLIVE is easy. Sign in to your account and access Virtual Visit to use MDLIVE. Note: You must register to use sentarahealthplans.com to use MDLIVE. 2. Choose a Doctor. Choose a board-certified doctor or licensed therapist from the nation’s largest virtual provider network. You can see the next available doctor on call ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Plans Member PortalThe MSBU also conducts proactive outreach to customer groups to assist with education on important employer and member resources and value-added services. For employer plans to cover 1-4 enrolled employees, contact our dedicated Micro Small Business Team at 1-888-706-2957. Micro Small Business Unit FAQs.2 Certain preventive care services and medications for individuals covered by an Sentara Health Plans insurance plan are available at no charge when administered by an in-network physician or pharmacy. An office visit copayment may be charged to health plan members for some services. For members with a new or renewing health plan or policy ...Sentara Medicare is a service of Sentara Health, recognized as one of the nation’s top 15 highest-performing health systems by IBM Watson Health 2. As part of the Sentara system, Optima Health operates with the same mission—to improve health every day. 1Members with chronic condition (s) that meet certain criteria may be eligible for this ...Sentara Medicare offers all-in-one Medicare Advantage plans with both medical and prescription drug coverage. Our plans provide more coverage than Original Medicare with benefits including a monthly grocery allowance*, a quarterly over-the-counter products allowance, dental, vision, and hearing allowances, and SilverSneakers®. Sentara Healthcare invests nearly $4 million in two new pipeline development programs to support students pursuing healthcare careers Sentara Community Care Achievements Sentara Community Care achieves measurable results in 2022, plans to expand across the Commonwealth in 2023 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered …Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Plans Member Portal Health insurance plans for individuals, families, businesses, Medicare, and Medicaid. Sentara Health Plans | Virginia Beach VA Sentara Health Plans, Virginia Beach, Virginia. 3,750 likes · 599 talking about this · 814 were here. As an Integrated Delivery Network (IDN) the change deepens the alignment between Sentara’s healthcare services and health plans. Sentara Health Plans will begin introducing the brand to the market this fall. In Virginia, all health plan members will receive Sentara Health Plans ID Cards around January 1, 2024.Sentara Medicare offers Medicare Advantage and special needs plans with dental, vision, hearing, and prescription drug coverage. Find the plan for you at a price you …Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Optima Health Code of Compliance. PDF, 143 KB Last Updated: 03/28/2023. PDF, 143 KB Last Updated: 03/28/2023. Access important Compliance documents. Sentara Health Plans provides health plan coverage to over 1 million members. 1 We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features ... EDI. Effective January 1, 2024, to process a claim, we require a valid W-9 for the provider tax identification number (TIN) on file with Sentara Health Plans. Claims submitted without a W-9 may be rejected by a clearing house or Sentara Health Plans, or administratively denied. We may require that any claim submitted without a valid W-9 on file ...Sentara Health Plans is here to help you get back on track with your preventive care, immunizations, and disease management as safely as possible. Emergency Travel Assistance. Sentara Health Plans offers a value-added service called Emergency Travel Assistance. These fully paid, global-emergency medical and travel services are provided … Sentara Health Plans is the new name of Optima Health, a trusted provider of healthcare services in Virginia and North Carolina. Learn how the name change affects you, your doctors, your benefits, and your prescription medicine coverage. Sign In. The resources listed here are intended for providers associated with Sentara Community Plan, the plan formerly known as Virginia Premier. If you forgot your username or need help with your password, call 1-877-814-9909 or email [email protected] the end of 2023, we retired the Optima Health and Virginia Premier brands unifying them under Sentara Health Plans beginning January 1, 2024. This change shows our steadfast commitment to our members and the communities we serve. The new brand identity is a representation of our growth and our promise to continue innovating and adapting in the …Thank you for choosing Sentara Health Plans. We are excited to serve the employees and family members of the City of Newport News. We encourage you to take some time to explore the plans and resources available to you as a Sentara Health Plans member. 2024 Benefits. Access plan documents and benefits information. Health and Wellness. …Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Plans For information on our Sentara Health Plans Commercial, Medicare, or Medicaid plans, please visit sentarahealthplans.com or call the numbers below: …Member Experience Advisors are available 24 hours per day, 7 days per week, 365 days per year. Language support services are available free of charge. Members: 800-928-1558 (TTY: 711) Hours of operation: 24/7/365. We understand the unique needs of our members, knowing that today's consumers are responsible for driving higher demand for their ...For urgent reviews: Practitioner should call Sentara Health Plans Pre-Authorization Department if they believe a standard review would subject the member to adverse health consequences. Sentara Health Plan’s definition of urgent is a lack of treatment that could seriously jeopardize the life or health of the member or the member’s ability to regain …Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ... Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ... Medicaid Eligibility for Adults. Adults may be eligible if you: are a Virginia resident, age 19 to 64. are a United States citizen or lawfully-residing immigrant. are not eligible or covered by Medicare. you are medically complex. meet the income requirements based on your household size. You may be eligible for a Dual Special Needs Plan (D-SNP ... Sentara Health Plans is a trade name of Sentara Health Plans, Sentara Health Insurance Company, Sentara Health Administration, Inc., and Sentara Behavioral Health Services, Inc. To verify the member’s benefits with Sentara Health Plans, please call: 1-800-229-8822 for medical or 1-800-648-8420 for behavioral health. v.0923.Access your plan, find care, pay your bill, and get discounts and cost estimates with Sentara Health Plans. Learn about COVID-19 resources, wellness programs, and … Your financial responsibility will depend on your medical plan benefits and may include a deductible, coinsurance or copays. It’s important to contact your insurance company before a medical procedure. To see a list of health insurance plans that Sentara accepts, select one of the links below: Health insurance plans accepted by Sentara hospitals. Language Assistance Services. Sentara Healthcare provides its patients and their families with qualified interpreters for languages other than English and for Sign Language (ASL). If you need a professional non-English spoken or sign language interpreter, please contact us at 844-809-6648. ወደ ሚከተለው ቁጥር ይደውሉ 844-809-6648. Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ... Find out which health insurance plans are accepted by Sentara hospitals and physicians. Learn about your financial responsibility, financial assistance and medical bill rights and …Health and Wellness. As part of an integrated health system, Optima Health truly believes in improving health every day. That’s why all of our health plans include MyLife MyPlan — a flexible health improvement program that helps members adopt healthy behaviors, reduce health risks, and lower healthcare costs.Required for payment: cash, your member ID number, and Code: 15084. Mail — in the form of a check, cashier's check, or money order mailed to: Optima Health, P.O. Box 715892 Philadelphia, PA 19171-5892. Pay by phone — pay with our Automated Attendant by calling 1–888–645–4306. The monthly bill is needed to use this option.Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara … Sentara Health Plans provides health insurance coverage to over 875,000 members through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees. With more than 55 years of experience ... Behavioral Health Claims: PO Box 8204, Kingston, NY 12402-8204. Timely Filing. As a reminder Sentara Health Plans allows 365 days for initial timely filing from the service date for all claims. For Medicaid, all PAR and non-PAR providers are given 365 days to file reconsideration claim. For non-PAR Medicare providers have 60 days from claim ... NEW Partial D-SNP: Sentara Community Complete Select (HMO D-SNP) If you are only partial dual eligible, you may qualify for some Extra Help, even if you don’t qualify for full benefits through Virginia Medicaid. Sentara Community Complete Select may be the plan for you. To see if you qualify, call a Licensed Plan Advisor at 1-855-434-3267 ... Call a Licensed Plan Advisor at 1-855-434-3267 (TTY: 711) Updated: September 30, 2023. Get answers to common questions about health insurance and help with understanding your healthcare options. These frequently asked questions will help you learn about Medicare, Medicare Advantage and the coverage you can receive.Sentara Health Plans is a trade name of Sentara Health Plans, Sentara Health Insurance Company, Sentara Health Administration, Inc., and Sentara Behavioral Health Services, Inc. To verify the member’s benefits with Sentara Health Plans, please call: 1-800-229-8822 for medical or 1-800-648-8420 for behavioral health. v.0923.Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...At the end of 2023, we retired the Optima Health and Virginia Premier brands unifying them under Sentara Health Plans beginning January 1, 2024. This change shows our steadfast commitment to our members and the communities we serve. The new brand identity is a representation of our growth and our promise to continue innovating and adapting in the … Sentara Health is a not-for-profit healthcare organization serving Virginia and northeastern North Carolina. It is based in Norfolk, Virginia and offers services in 12 acute care hospitals, with 3,739 beds, 853,000 members in its health plan, [1] 10 nursing centers, and three assisted living facilities across the two states. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara … Sentara Health is a not-for-profit healthcare organization serving Virginia and northeastern North Carolina. It is based in Norfolk, Virginia and offers services in 12 acute care hospitals, with 3,739 beds, 853,000 members in its health plan, [1] 10 nursing centers, and three assisted living facilities across the two states. Sentara Health Plans provides health plan coverage to over 1 million members. 1 We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features ... Sentara Health Plans partners with Rainbow Puppets to create a program that brings puppet shows to children. The shows feature puppets, music, and dance, and highlight that reading is fun! Puppet shows are held at Title 1 schools, libraries, recreation centers, and local events. Sentara Health Plans. More than 1 million commercial, Medicaid, and Medicare health plan members in Virginia and Florida. Sentara Medical Group (SMG) More than 1,500 quality physicians and advanced practice providers completing more than 2.8 million patient visits each year. Sentara College of Health SciencesSentara Medicare offers Medicare Advantage and special needs plans with dental, vision, hearing, and prescription drug coverage. Find the plan for you at a price you … New Look for our Search Tool. Enjoy a new look and exciting features of our provider search tool! Search for primary care providers (PCPs) that are in-network and accepting new patients all at a glance. Find providers close to you with interactive maps. Send advanced search results via email. Learn more about these new features. Sentara Health Plans provides health plan coverage to over 1 million members. 1 We offer a full suite of commercial products including employee-owned and employer-sponsored plans, as well as Individual & Family Health Plans, Employee Assistance Programs and plans serving Medicare and Medicaid enrollees. Our quality provider network features ... Please mail your payment, along with the payment stub from your monthly bill, to P.O. Box 715892, Philadelphia, PA 19171-5892. Please note: your payment must be received by the last day of the month. Telephone. Call 757-687-6434 or 1-888-737-5479 and select option 2 to pay by phone with an Sentara Health Plans representative. Provider Directories. As of January 1, 2023, Virginia's Medicaid program is now rebranded to Cardinal Care. This program provides all healthcare coverage for Medicaid members under one brand. To support this, our provider directories for Medallion 4 and CCC+ have been combined. The updated directory is now available. To find out more about ... Sentara Health Plans offers health coverage for groups, individuals, Medicaid, and Medicare in Virginia and Florida. It is part of Sentara Health, a not-for-profit health system with over 130 years of history and mission. Schedule an appointment. Call a Licensed Plan Advisor at 1-855-434-3267 (TTY: 711) Updated: September 30, 2023. Get answers to common questions about health insurance and help with understanding your healthcare options. These frequently asked questions will help you learn about Medicare, Medicare Advantage and the coverage you can receive.Sentara Health Plans offers affordable and quality health coverage for individuals and families in Virginia. Choose from Direct or Standard plans, with essential health …Sentara Health Plans Member Services. PO Box 66189, Virginia Beach, VA 23466. Phone:757-552-7401; 1-877-552-7401; TTY Relay 1-800-828-1140 or 711. If you believe that Sentara Health Plans has failed to provide these services or discriminated in another way based on race, color, national origin, age, disability, or sex, you can file a grievance ...Authorization for Use or Disclosure of Medical Information (Designated Representative) PDF, 115 KB Last Updated: 12/21/2023. PDF, 115 KB Last Updated: 12/21/2023. Find important documents and forms relating to your Sentara Family Care and Sentara Health Plans Community Care Medicaid plan.
Optima Health Code of Compliance. PDF, 143 KB Last Updated: 03/28/2023. PDF, 143 KB Last Updated: 03/28/2023. Access important Compliance documents.. Regentpay
Sentara Health Plans Financial Wellness Program. Just like your body benefits from a diet and exercise plan, your financial health benefits from a budgeting and savings plan. The Sentara Health Plans Financial Wellness Program in partnership with FinFit® offers you tools and experts to help you become better managers of your money.Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Plans offers affordable health plans for individuals and families in Virginia. Compare plans, find providers, and enroll online or contact a personal plan …Sentara Health Plans, Virginia Beach, Virginia. 3,750 likes · 599 talking about this · 814 were here. Health insurance plans for individuals, families, businesses, Medicare, and Medicaid.Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Plans offers health insurance plans for individuals, families, employers, Medicare, Medicaid and more. Learn about the new name, virtual care, discounts, wellness programs and COVID-19 resources.Sentara Health Plans offers affordable and quality health coverage for individuals and families in Virginia. Choose from Direct or Standard plans, with essential health …Pharmacies that wish to be included in the Sentara Health Plans Specialty Pharmacy Network should contact Sentara Health Plans at 757-552-7474 or 1-800-229-8822. Limited Distribution Drugs (LDD) Some specialty drugs are limited distribution drugs (LDD), meaning only specific pharmacies can dispense the medication. In the event that …Required for payment: cash, your member ID number, and Code: 15084. Mail — in the form of a check, cashier's check, or money order mailed to: Optima Health, P.O. Box 715892 Philadelphia, PA 19171-5892. Pay by phone — pay with our Automated Attendant by calling 1–888–645–4306. The monthly bill is needed to use this option.All Sentara Health Plans Medicare and Medicaid products require an active PaySpan Account. To start the PaySpan registration process, you may contact [email protected] or call 1-877-331-7154, option 1 to obtain the registration codes and assistance with navigating the website. Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ... Sentara Health Plans, formerly Optima Health offers Individual & Family health plans that can help lower the cost of your health insurance with a Marketplace plan. Talk to one of our Personal Plan Advisors at 1-855-434-3253 to see if you qualify for a subsidy. Sign up for a Marketplace health plan within 90 days of losing your Medicaid coverage ....