Behavioral Billing® Credentialing Guide
Sentara Health Plans
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
Do not assume behavioral-health participation includes speech therapy, or that an SLP network contract includes behavioral-health services.
Mental / Behavioral Health provider
Behavioral-health credentialing route
Use Sentara's behavioral-health network/credentialing route. Current behavioral-health network availability is time-sensitive and should be checked before applying.
Open BH credentialing source ↗Speech Therapy provider
Speech / therapy credentialing route
Use Sentara's ancillary/therapy provider credentialing route for Speech Therapy and confirm network availability for the SLP provider type.
Open speech credentialing source ↗Where the pathways differ: Sentara behavioral-health participation and ancillary/therapy participation are distinct operational tracks. A BH network restriction should not automatically be applied to SLP.
Shared credentialing + network setup
Credentialing prerequisitesProvider/group information complete; current Sentara network status must be confirmed before billing.Open source ↗
Network / payer enrollmentUse Sentara network/credentialing process; verify behavioral and ancillary/speech participation separately where applicable.Open source ↗
State Medicaid enrollmentFor Community Plan, complete Virginia DMAS/MES enrollment before MCO go-live.Open source ↗
Portal / identity setupAvaility and/or Sentara portal access by function.Open source ↗
Revenue-cycle enrollment
EDI / claims enrollmentUse Sentara EDI/Availity claims route; exact Medicaid electronic payer ID remains varies by payer.Open source ↗
ERA enrollmentUse current Sentara remittance/ERA setup; verify current portal/vendor enrollment.Open source ↗
EFT enrollmentUse current Sentara EFT/payment setup; verify current portal/vendor enrollment.Open source ↗
Clearinghouse / EDI routeSentara EDI + Availity transitionOpen source ↗
Payer IDProduct-specific; Medicaid electronic ID still not yet confirmed in the payer’s public materialsOpen source ↗
Before you start billingConfirm network effective date, portal access, electronic payer route, claim acceptance, remittance receipt and payment destination before production billing.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 · Some enrollment requirements vary by product; confirm before applying
Payer processes change. Reverify the current payer instructions before submitting an application or changing a production billing configuration.