3rd Quarter Let’s Talk Behavioral Health - August 12, 2025 - Meeting recording policy and agenda

Sep 12, 2026

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Agenda and key updates for a Sentara Health Plans “Let’s Talk Behavioral Health” webinar dated August 12, 2025. The materials emphasize compliance with the meeting recording policy, explicitly prohibiting Otter.ai and similar AI notetaking platforms. Content covers 2025 updates, including new provider services hours for Virginia Cardinal Care Managed Care Medicaid providers and Electronic Visit Verification (EVV) claims editing improvements. It also highlights member experience initiatives such as Welcoming Baby and guidance on where members should go for urgent but non-emergency care.

LanguageEnglish

CategoryPresentations

FormatPDF

Pages41

Reading Time14 min

AccessFree to download

Agenda

What’s New at Sentara Health Plans in 2025

Member Experience

Where To Go for Care

Good Afternoon! Thank you for waiting while we gather. NOTE: [Using Otter.ai](Using Otter.ai) or similar artificial intelligence notetaking platforms violates Sentara Health Plans’(SHP) meeting recording policy. Please do not use any such platforms while attending SHP webinars. We appreciate your cooperation. 3rd Quarter Let’s Talk Behavioral Health August 12 , 2025 NOTE: [Using Otter.ai](Using Otter.ai) or similar artificial intelligence notetaking platforms violates Sentara Health Plans’(SHP) meeting recording policy. Please do not use any such platforms while attending SHP webinars. We appreciate your cooperation. Agenda 1. What’s New at Sentara Health Plans in 2025 2. Member Experience 3. DMAS Updates/Follow-up 4. Billing Reminders, Authorization Updates and Important Reminders 5. Sentara Health Plans Behavioral Health Utilization Management Provider Updates-Cindy Hobbs, RN, MS-Director, Behavioral Health UM 6. Sentara Health Plans Medicaid Behavioral Health Redesign-Kresha Garland, PsyD-Director, Behavioral Health Contracting, LTSS & SCAs What’s New at Sentara Health Plans in 2025 New Provider Services Hours for Medicaid Providers Effective July 1, 2025, provider services extended their hours [from 7 a.m. to 7 p.m](from 7 a.m. to 7 p.m). , Monday through Friday, for Medicaid providers who are part of the Virginia Cardinal Care Managed Care program through DMAS. Electronic Visit Verification Claims Editing Improvements Sentara Health Plans and Availity will be making improvements to Electronic Visit Verification (EVV) claims editing. This improvement will be implemented on or after September 15, 2025, and will consist of the following components: Sentara Health Plans will be updating its EVV claims editing logic to ensure individual EVV required data elements are being captured for both primary and secondary Medicaid members to allow for easier provider assistance on claims questions. There will be quicker notification and claim rejection from Availity when required EVV elements are missing from the submitted claim at the clearinghouse level. The additional claims editing logic will be reviewing claims for both primary and secondary Medicaid enrolled members, in alignment with the Department of Medical Assistance Services (DMAS) requirements. Sentara Health Plans Portal Features Update Provider Portals | Providers | Sentara Health Plans Member Experience Welcoming Baby Welcoming BabySM is an incentive-based program that provides Sentara Health Plans Medicaid members with a variety of clinical and personal resources and ongoing support during and after pregnancy. Medicaid members now have access to view the following online: • frequently asked questions • maternal health benefits • education and events and resources The Sentara Health Plans health and wellness page now provides a link to our maternal health programs: • Welcoming Baby for Medicaid members • Partners in Pregnancy for commercial and Medicare members Welcoming Baby: Welcoming Baby | Medicaid | Sentara Health Plans Maternal health: Maternal Health Benefits | Medicaid | Sentara Health Plans Proprietary and Confidential 9 Where To Go for Care As part of Sentara Health Plans’ continued efforts to ensure our members access the right level of care at the right time, we want to educate our providers about the many alternatives available to members for receiving care for urgent or non-lifethreatening conditions outside of the Emergency Department. Please review the flyer at this link for assistance in referring Sentara Health Plans Medicaid members, SHP_MD_MEM_FL_240038 Where to Go for Care (Oct 2024 update)_Web.pdf

FAQs

What is the meeting recording policy for SHP webinars mentioned in the document?

Using Otter.ai or similar AI notetaking platforms violates Sentara Health Plans’ meeting recording policy. Attendees are asked not to use these platforms while attending SHP webinars.

What changes were announced for provider services hours for Medicaid providers?

Provider services hours were extended effective July 1, 2025 to 7 a.m. through 7 p.m., Monday through Friday, for Medicaid providers under the Virginia Cardinal Care Managed Care program through DMAS.

What EVV claims editing improvements are scheduled?

Sentara Health Plans and Availity will update EVV claims editing logic on or after September 15, 2025 to ensure required EVV elements are captured for both primary and secondary Medicaid members and to enable quicker notification and claim rejection when elements are missing at the clearinghouse level.

Sep 12, 2026

Upload by Liam