Behavioral Billing® Credentialing Guide
Sentara Community Plan
Credentialing and revenue-cycle enrollment reference for behavioral health and speech therapy practices. Start with your provider type: the credentialing route may differ even when the insurance brand is the same.
Choose the correct provider pathway
Mental / behavioral health and speech therapy can sit in different payer networks even under the same insurance brand.
Mental / Behavioral Health provider
Behavioral-health credentialing route
Complete DMAS/MES plus Sentara Community Plan network/credentialing process. Confirm BH-specific participation requirements.
Open BH credentialing source ↗Speech Therapy provider
Speech / therapy credentialing route
Complete DMAS/MES plus Sentara Community Plan network/credentialing process. Confirm the SLP/therapy provider type; do not assume BH participation covers speech therapy.
Open speech credentialing source ↗Where the pathways differ: Credentialing may share a network framework, but benefit and authorization workflows remain specialty-specific.
Shared credentialing + network setup
Credentialing prerequisitesVirginia Medicaid enrollment active; current Sentara network status verified.Open source ↗
Network / payer enrollmentComplete DMAS/MES plus Sentara Community Plan network/credentialing process.Open source ↗
State Medicaid enrollmentRequired — DMAS/MES.Open source ↗
Portal / identity setupAvaility and Sentara portal registration by function.Open source ↗
Revenue-cycle enrollment
EDI / claims enrollmentUse Sentara EDI / Availity route; exact electronic payer ID remains pending official public source.Open source ↗
ERA enrollmentUse current Sentara Medicaid remittance enrollment; verify portal/vendor path.Open source ↗
EFT enrollmentUse current Sentara Medicaid EFT enrollment; verify portal/vendor path.Open source ↗
Clearinghouse / EDI routeSentara EDI + AvailityOpen source ↗
Payer IDElectronic payer ID not yet confirmed in the payer’s public materialsOpen source ↗
Before you start billingConfirm MCO participation, portal access, claim route, remit path and EFT before first Medicaid claim.Open source ↗
Before you bill: provider credentialing, specialty network participation, EDI, ERA, and EFT are separate checkpoints. Verify the correct specialty network before treating the first member.
Last reviewed: 2026-09-09 · Core setup reviewed; confirm payer ID and remaining credentialing details
Payer processes change. Reverify the current payer instructions before submitting an application or changing a production billing configuration.