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Claims and EDI Forms (In-Network Providers)

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Claims and EDI Forms (Out-of-Network Providers)

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Contracting

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Medical Management

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Provider Manuals and Training

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Provider Notices

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  • Changes to Hearing Benefit for Pediatric Patients Take Effect October 1

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

Optima Health is the trade name of Optima Health Plan, Optima Health Insurance Company, and Sentara Health Plans, Inc. Optima Health Maintenance Organization (HMO) products, and Point-of-Service (POS) products, are issued and underwritten by Optima Health Plan. Optima Preferred Provider Organization (PPO) products are issued and underwritten by Optima Health Insurance Company. Sentara Health Plans, 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. Optima Health Medicare, Medicaid, and FAMIS programs are administered under agreements with Optima Health and the Centers for Medicare and Medicaid Services (CMS) and the Virginia Department of Medical Assistance Services (DMAS).