Payer ID
54154
EDI payer ID 54154 (Sentara Health/Optima Health); some legacy lines may use different IDs.
Timely Filing Limit (TFL)
365 days from date of service for initial claims
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse
Availity; also Veradigm and Change Healthcare
Provider Services
800-229-8822
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Medical: PO Box 8203, Kingston, NY 12402-8203; Behavioral health: PO Box 8204, Kingston, NY 12402-8204
Provider Portal
https://www.sentarahealthplans.com/en/providers/provider-portals
Virginia-based; formerly Optima Health. Also Medicaid (Sentara Community Plan) and Medicare.
Values vary by plan, region, and contract and can change. Confirm in the payer portal or with your clearinghouse before filing.
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