Claims

The Claims Department is committed to providing you with the highest level of service possible. Our mission is to pay claims correctly and quickly the first time. Doing it right the first time saves time and money for everyone. We want to help you improve the premier health outcomes of our members by reducing the time you spend on claims follow-up.

If you have questions for the Claims Department or suggestions on how we can improve our operations, please call us at 877-739-1370, press 3 for Providers then press 2 for Claims. Our fax number is 877-739-1362.

Claims Forms

All of our forms can be found in the Claims section of the Provider Forms Library

Clearinghouses

Virginia Premier Elite, Platinum and Gold Plans are pleased to be partnering with two of the largest clearinghouses in the industry to provide a full range of electronic capabilities for our providers and network partners. Our clearinghouse information is shown below: 

Clearinghouse
Phone
Email
837 Claims Professional
837 Claims Institutional
835 ERA
Availity
800-282-4548
support@availity.com
YES
YES
YES
RelayHealth
800-527-8133
DBQTSHInsuranceSupport@RelayHealth.com
YES
YES
YES
Availity
RelayHouse
Phone
800-282-4548
800-527-8133
Email
Click to Email
Click to Email
837 Claims Professional
YES
YES
837 Claims Institutional
YES
YES
835 ERA
YES
YES

Resources

By logging in to this portal, I affirm that I have read, understand and agree to abide by the following terms and conditions: 

I certify I am a health care provider, an employee of a health care provider, a business associate of a health care provider, or an employee of a business associate, and the purpose of my access to any Virginia Premier System is related to the provision or payment of health care services.

With respect to all information viewed or obtained from this site, I agree to comply with all applicable federal and state laws regarding the confidentiality and integrity of health and medical records. This includes full compliance with the Health Insurance Portability and Accountability Act of 1996 (‘HIPAA’), the HITECH Act, and the Virginia Health Records Privacy Act, and applicable regulations to these laws.

I agree to keep confidential all information related to Virginia Premier System business, including, but not limited to, quality and risk management activities as well as other confidential or personal information concerning the medical, personal, or business affairs of Virginia Premier System and its members.

I agree to notify Virginia Premier System immediately in the event that my network access has been compromised in any way and in the event of unauthorized use or disclosure of any information obtained from the Virginia Premier System network.

Need to register for a new account? Click here.

In order to register for an account, if you would like access to all group NPIs/APIs under a single Tax ID, please enter your Tax ID only. If you would like access to a specific group NPI/API instead, please enter it in the field provided. 

For expedited registration, please provide a Claim number and the Total Billed Charges on the claim when creating your account.

You will receive an email within 3-5 business days with your username and temporary password.

Please call Technical Support for help with Virginia Premier’s Provider Portal at 1-877-814-9909 or email connect@healthtrio.com. 

Virginia Premier is offering EFT services through PaySpan.

Please click here to sign-up

If you have questions or need help please, contact our Provider Services department at vphpnetdev@sentara.com or by calling 804-968-1529.