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Cardinal Care Implementation

September 1, 2023, Optima Health will merge its Medallion 4.0 and CCC+ Medicaid programs under one new program and product name. This transition ensures alignment with statewide changes led by the Virginia Department of Medical Assistance Services (DMAS).

A phased-in strategy began on July 1, 2022, allowing adequate time to prepare as well as inform members, providers and others about the new program, and ensure members have seamless access to the care, services and assistance they need.

Appropriate changes will unfold at Optima Health to accommodate the program implementation. The most critical announcements will be made through Cardinal Care Alert broadcast emails as well as the quarterly providerNEWS newsletter. To supplement these modes of communication, we have created this web page to track various milestones throughout this process in a convenient, at-a-glance format. This page is temporary and will remain active for a limited time.

We invite you to visit this page at any time to stay updated.

Milestones Achieved

  • New Medicaid Product: Name Selected

    Beginning September 1, 2023, Medallion 4.0 and CCC+ will operate as a single managed care delivery system under one product name,Optima Community Care.

  • Cardinal Care Alert Announcing: New Product Name Sent
  • Provider Agreement: Updated

    In lieu of reissuing new agreements, we published Virginia Medicaid regulatory updates to provider agreements on our website as well as in the fourth quarter issue of providerNEWS on November 1, 2022.

  • New Consolidated Provider Manual: Available Online

    Our core Provider Manual and Medallion 4.0 and CCC+ supplements have been consolidated and edited to reflect the new program and product brand names.

  • Member ID Card Sample: Available Online

    A new Member ID card has been created and includes the new product name and logo.

  • Cardinal Care Alert Announcing New ID Card Distribution: Sent
  • Cardinal Care Alert Announcing Provider Manual Release: Sent
  • Provider Resources: Updated and Available Online

    All pre-existing provider resources, such as the website, educational materials, brochures, etc. have been updated to reflect new branding and product names and re-released.

  • Transitioning to Cardinal Care Orientation: Available Online

    We have developed provider education materials to relay how Optima Health has implemented Cardinal Care. A slide presentation is available on our website so you can review it at your convenience.

  • Transitioning to Cardinal Care Provider Webinar Registration: Open

    A Cardinal Care Alert announcing multiple live presentations of Transitioning to Cardinal Care with question-and-answer opportunities has been sent. Registration is now open.

  • Member ID Card Mailing: Completed

    Cardinal Care implementation has been postponed to September, 2023. New member ID cards bearing the Cardinal Care logo have been mailed to new and existing members and should have been received. Cards will become effective on January 1, 2023 and members are encouraged to begin presenting them. However, due to the delay in implementation, you may continue accepting the original ID card if presented.

    Note: Some members (excluding FAMIS and OHCC) received incorrect ID cards which included the FAMIS logo and did not have the transportation phone number. Cards have been reissued. For member and provider convenience, digital images of all ID cards will be available in the member and provider portal as well as the mobile app prior to distribution.

  • Cardinal Care Alert Announcing Issuance of New Member ID Cards to New and Existing Members: Sent
  • Cardinal Care Alert Announcing New Optima Community Care Orientation Materials: Sent
  • New Optima Health: Doing Business With Us Guide and Early and Periodic Screening Provider Education: Available Online
  • Model of Care: Available Online

DMAS Cardinal Care Websites

https://www.dmas.virginia.gov/for-members/cardinal-care/

https://www.dmas.virginia.gov/for-providers/cardinal-care-transition/


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© Optima Health 2023, PO Box 66189, Virginia Beach, Virginia 23466

Sentara Health Plans and Optima Health are trade names of Sentara Health Plans, Sentara Health Insurance Company, Sentara Health Administration, Inc., and Sentara Behavioral Health Services, Inc. Optima Health Insurance Company is an additional trade name for Sentara Health Insurance Company. Virginia Premier Health Plan is an additional trade name for Sentara Health Plans. Optima Behavioral Health is an additional trade name for Sentara Behavioral Health Services, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Sentara Health Plans. Optima 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 Optima Health 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 with Sentara Health Plans and the Virginia Department of Medical Assistance Services (DMAS.)