Alerts

This week, we are sharing the following provider updates: Medicaid member benefit change—continuous glucose monitors, DMAS memo: change from RUG-IV to PDPM grouper for nursing facility claim payments. upcoming educational opportunities, and more.

This week, we are sharing the following provider updates: Authorization Updates Effective December 1, Prior Authorization Updates for Medicaid Effective October 1, Quest Diagnostics Reminder, and Upcoming Educational Opportunities.

This week, we are sharing the following provider updates: Prior Authorization Process Improvements, Anatomical Modifiers Update, and more.

This week, we are sharing the following provider updates: Authorization Updates Effective November 1, Provider Satisfaction Survey, New Quest Rapid Respond Laboratory in Richmond, and more.

This week, we are sharing the following provider updates: Authorization Updates Effective October 1, Reminder: Use of Individual Business Email Address for Provider Portal Registration, and more.

This week, we are sharing the following provider updates — Electronic Visit Verification Claims Editing Improvements, Use Appropriate Modifiers for New or Rented Durable Medical Equipment, Upcoming Educational Opportunities, New Provider Services Hours for Medicaid Providers, Provider Satisfaction Survey, Reminder: Fax Numbers for Medicaid Behavioral Health Prior Authorization Requests, Medical Respite Care for Members Experiencing Homelessness – ICD-10 Code List Updated, DMAS Updated Fee Schedule for July 1, 2025

This week, we are sharing the following provider updates: Reminder: Quest Diagnostics is Sentara Health Plans’ Exclusive Lab Provider, Provider Agreement Required Documents Address, Post Acute MS, DRG Claims Edit, Upcoming Educational Opportunities, Sentara Health Plans Portal Features Update, New Provider Services Hours for Medicaid Providers, Therapeutic Day Treatment Summer Program Authorization Requests, and Medicaid and Medicare Behavioral Health Authorization Requests.

This week, we are sharing the following provider updates: Correction: Provider News, Reminder: Quest Diagnostics is Sentara Health Plans Exclusive Lab Provider, New Verification Forms for Medicare, Behavioral Health Updates, New Provider Services Hours, Upcoming Educational Opportunities.

This week, we are sharing the following provider updates : Authorization Updates Effective August 1, Policy Updates Effective August 1, and Pharmacy Update.

This week, we are sharing the following provider updates: New GLP-1 Formulary Provider Resource, Payment Policies for Readmission for Commercial and Repeat Admission Medicare – Effective July 1, Carefully Review All Claims Before Submission, Upcoming Educational Opportunities, Authorization Updates Effective July 1

This week, we are sharing the following provider updates: Portal Features Update, OncoHealth Authorization Submission—Enter the Correct Place of Service, Upcoming Educational Opportunities

This week, we are sharing the following provider updates: Reimbursement for Rental of DME, Reminder: Three-Day Payment Window Policy, Utilization Management Process Improvements Coming Soon, Upcoming Provider Quality Care Learning Collaborative Webinar, Authorization Updates Effective June 1

This week, we are sharing the following provider updates — Home Infusion Services Authorizations Transitioning to Sentara Health Plans, Member ID Cards Accessible in Availity, Quest Diagnostics Location Search Tool.

This week, we are sharing the following provider updates: OncoHealth Oncology Benefits Management Program is Now Live, Attention LTSS Providers—We Are Retiring the PCH Portal, Member Rights and Responsibilities, Dual Eligible Special Needs Plan, Model of Care Provider Guide

This week, we are sharing the following provider updates — Urgent: Sentara Medicare Engage Members May Lose Coverage on February 28—Please Act Today, Personal Care and Behavioral Health Services—Billing Reminder, Evolent—Ambulatory Service Centers (Commercial Member Authorizations Only), Incorrect Date of Birth and Member ID Number, Authorization Updates Effective May 1

This week, we are sharing the following provider updates: Urgent: Sentara Medicare Engage Members May Lose Coverage Soon—Please Act Today, OncoHealth to Administer Oncology, Benefits Management Program, Zelis Payments Network—Reminder, Virginia Medicaid Billing—Personal Care Services and Respite Care Services, Centers for Disease Control and Prevention's STEADI Fall Prevention Training, Look for Our Upcoming 2025 Webinars

This week, we are sharing the following provider updates — NPI and TIN Required to Authorize Vendor Imaging and Cardiac Services, OncoHealth to Administer Oncology Benefits Management Program, Sentara Health Plans to Resume Management of Post-acute Care, Home Infusion Therapy and Sleep Service Authorizations, and Authorization Updates Effective April 1.

This week, we are sharing the following provider updates - Educational Opportunities and Important Updates

This week, we are sharing the following provider updates — Authorization Updates Effective March 1

This week, we are sharing the following provider updates - Early Alert: Infusion Pump Issue from Fresenius Kabi USA