Medicaid managed care network providers must enroll through PRSS (Provider Services Solution) to satisfy federal requirements in the 21st Century Cures Act. Those currently enrolled as FFS in Medicaid do not have to re-enroll.
Attention Medicare Providers
Optima Health has discovered an error with Medicare ID cards distributed to members for 2023 and action is required to avoid claims submission denials.
Learn More
Normal Medicaid Enrollment Processes Will Start Soon
There are several ways to help your Medicaid members prepare for the Public Health Emergency (PHE) Unwinding.
Get the details and find out how you can help
Supporting Members as COVID-19 Spreads
As your partner in health, we are taking steps to protect and educate our members about the coronavirus (COVID-19) as it spreads throughout our nation.
Learn about actions we are taking to support our members | Frequently asked questions for Providers | Vaccine Information for Providers (PDF)
Provider Support
Provider Webinars
Our Quarterly Provider Webinars help keep our Provider Community informed. Learn more about our webinar schedule and register for one of our upcoming webinars today!
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Transportation Benefit
Do you need more information to help coordinate transportation services for your patients?
Learn About Transportation Services
Cultural Competency Attestation
Have you participated in Cultural Competency training? You must complete this acknowledgement in order to be credited with the completion of this training.
Get Credit
Optima Health Community Care and Optima Community Complete (D-SNP)
Are you a participating Optima Health Community Care or an Optima Community Complete provider? Please complete these courses to learn about doing business with Optima Health Community Care, CCC Plus and Optima Community Complete.
Take the Courses
Fraud, Waste and Abuse
Learn more about fraud, waste, and abuse; including its definition, examples, prevention, and your responsibilities as a provider.
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Supplemental Resources
This page contains supplemental resources to help you provide the best possible care to Optima Health members.
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Please email us at websuggestions@sentara.com to tell us how we may improve this website to make doing business with Optima Health easier.
News
Provider Training Opportunity: Home Sleep Study Authorizations via CareCentrix
By now, you should have received communications from Optima Health and CareCentrix® notifying you about the relationship between our organizations that will take effect on March 1, 2023 for sleep testing services (HST) provided to Optima Health members covered under commercial plans in Virginia.
Optima Health Will Temporarily Relax Authorization Requirements
Effective January 13, 2023, discharge to Optima Health in-network post-acute facilities will not require prior authorization.