Electronic Claims Submission and EFT Payments

Optima Health recognizes the strain the COVID-19 pandemic has put on our members, in particular, and is aligned with our provider partners to ensure our shared customers have access to the care they need when they need it. We also understand that these difficult times make the timely and accurate payment of claims a common and heightened provider concern.

Now more than ever, Optima Health encourages and prefers electronic claims filing and payment. These methods will simplify your transactions with Optima Health and expedite your payments.

Electronic Data Exchange (EDI)

Optima Health accepts claims through any clearinghouse that can connect through Payerpath/Allscripts. Some EDI vendors also include electronic remits in their package. Providers who submit claims electronically will enjoy several benefits, including:

  • documentation of claims transmission
  • faster reimbursement
  • reduced claim suspensions
  • lower administrative costs

We encourage you to contact your preferred EDI vendor today.

Electronic Funds Transfer (EFT)

Our EFT transactions are a safe, efficient, and more secure, and an efficient method of receiving your claims payments.

  • Funds are deposited within 24 hours after payments are processed.
  • Clean claims are processed and paid within an average of seven days when submitted electronically and payment is made through EFT.
  • You will be notified via email when a deposit is made to your bank account.

Sign up for EFT with the Electronic Payment/Remittance Authorization Agreement by following the manual process as outlined. Submit your enrollment forms or direct any questions to EFT_ERA_Inquiry@sentara.com.

Provider Connection

Providers who register for Provider Connection can electronically access member eligibility, create medical authorizations, view authorizations, view and reconsider medical claims, clear claim connection and view/print remits.

Register for Provider Connection