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Sentara Health Plans

Sentara Health Plans

This page contains information you can use to exchange healthcare transactions with Sentara Health Plans using Stedi.
Use any of the following payer IDs to send transactions to Sentara Health Plans using Stedi APIs or SFTP. Read the docs
Primary Payer ID
54154
Stedi Payer ID
ADNKL
Payer ID aliases
00453, 10477, 1285, 54154, 54154MA, 5415M, 7499, OPTSNT, ULACG, VACMS, YEXEB
Parent group
Sentara Health Management Group
Coverage types
Dental, Medical

Supported transactions

Use Stedi to exchange the following transactions with Sentara Health Plans using APIs or SFTP. Send transactions as JSON or raw EDI files.
Eligibility & benefit verification
Supported

Eligibility checks

(270/271)
Verify member coverage and benefits by sending real-time and batch eligibility checks to Sentara Health Plans.
Not supported

Coordination of benefits checks

(COB)
Submit coordination of benefit checks to Sentara Health Plans to determine if a member has overlapping coverage with another plan and determine each payer's responsibility for paying claims.
Claims processing
Supported

Real-time claim status

(276/277)
Check on the status of a claim previously submitted to Sentara Health Plans in real-time by sending a claim status check (276/277).
Supported, enrollment required

Professional claims

(837P)
Submit professional claims to Sentara Health Plans and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Institutional claims

(837I)
Submit institutional claims to Sentara Health Plans and receive 277 claim acknowledgments asynchronously.
Supported, enrollment required

Claim payments

(835 ERA)
Receive electronic remittance advice (ERAs) from Sentara Health Plans to review full payment details.
Not supported

Dental claims

(837D)
Submit dental claims to Sentara Health Plans and receive 277 claim acknowledgments asynchronously.
Not supported

Unsolicited claim attachments

(275)
Receive unsolicited attachments for claims submitted to Sentara Health Plans.
Get started
Use Stedi's APIs to get fast and reliable connectivity to Sentara Health Plans and start processing healthcare claims and eligibility checks within minutes.
Start processing healthcare claims and eligibility checks with Stedi and Sentara Health Plans today.
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Other names
Alternative known names, networks, or health plans for this payer that may appear on insurance cards, claims, or other correspondence.
  • Optima Health Behavioral Health
  • Optima Health Community Care
  • Sentara Behavioral Health Services
  • Sentara Health Administration
  • Sentara Health Insurance Company
  • Sentara Health Management
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