Sentara Health Plans is undergoing a significant transformation in its provider portal services, transitioning from the Virginia Premier Provider Portal to a more streamlined, user-friendly platform. This comprehensive article explores the upcoming changes and what healthcare providers need to know about this critical digital infrastructure update.
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What is Changing?
Effective December 31, 2024, Sentara Health Plans will retire the Virginia Premier Provider Portal. The primary goal of this transition is to consolidate and streamline self-service capabilities, delivering a more efficient experience through the Availity multi-payer portal.
Who Can Use the New Platform?
The new Availity platform is designed for:
- Healthcare providers
- Medical practices
- Clinics
- Hospitals associated with Sentara Health Plans
Key Features in Availity
Starting November 1, 2024, providers will be able to:
- Check patient eligibility and benefits
- Submit claims using data entry inputs
- Check claim status
- View remittance advice
- Access Sentara Health Plans-specific resources
Access and Registration
For New Availity Users
- Visit Availity’s “Get Started” page
- Complete registration process
- Navigate to “Help and Training” for additional resources
For Existing Availity Essentials Users
- Use existing user ID and password
- Note: Not all Sentara Health Plans features are currently available
Claim Reconsideration Process
Interim Solution
Until Spring 2025, providers can:
- Use payertransactions.com Claim Reconsideration Portal
- Convert existing HealthTrio account to a direct-login account
Long-term Solution
- Claim Appeals/Reconsiderations will be available in Availity by Spring 2025
Important Transition Dates
- November 1, 2024: Initial Availity features launch
- December 31, 2024: Virginia Premier Provider Portal retires
- January 1, 2025: Full transition to Availity
Account Migration and Security
Account Conversion
- Migrate existing TINs to a single direct-login account
- Two-factor authentication (2FA) required
- Confirmation email will be sent during migration process
Limitations and Considerations
- Claim status available for one year from submission date
- For older claim statuses, contact Provider Services
- Manual account review may be required for some conversions
Customer Support
For registration issues or assistance:
- Provider Services: 1-800-881-2166
- Hours: 8 a.m. to 6 p.m., Monday-Friday
Privacy and Security
Sentara Health Plans ensures:
- Compliance with federal civil rights laws
- Non-discrimination policies
- Secure data handling
Unprovided Information
Some specific details about the full feature set in Availity are not yet available and will be communicated as the transition progresses.
The transition to Availity represents Sentara Health Plans’ commitment to providing healthcare providers with a more efficient, user-friendly digital platform. Providers are encouraged to start preparing for this change and familiarize themselves with the new system.
Last Updated: August 2025
FAQ
What is Virginia Premier called now?Starting July 1, 2023, Virginia Premier Medicaid will become a part of Sentara Health Plans. The Virginia Premier Medicaid product will now be branded Sentara Health Plans and the Virginia Premier name will no longer be in use for Medicaid.
What type of insurance is Virginia Premier?Virginia Premier, which provides Medicaid coverage to more than 300,000 Virginians, will move its Medicaid membership to Optima Health effective July 1, 2023.May 10, 2023
Is Virginia Premier going to change to Optima health?Effective July 1, Virginia Premier will rebrand as Optima Health. The health plans are transitioning to full integration on January 1, 2024. Optima Health Group Number VP = the health plan formerly known as Virginia Premier.
What is the phone number for Virginia Premier Claims Provider?
| MCO | Phone | |
|---|---|---|
| Optima Health | [email protected] | |
| United | [email protected] | 844-284-0146 |
| Virginia Premier | [email protected] | 1-877-719-7358 and follow the prompts to reach Claims |
| 804-968-1529 |
https://www.sentarahealthplans.com/en/providers/virginia-premier/sign-in
This portal will be retiring effective 12/31/24. Please see the Frequently Asked Questions for more information. User ID: Password: Sign In.
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When is the Virginia Premier Provider Portal retiring? Sentara Health Plans will retire the Virginia Premier Provider. Portal effective December 31, 2024.