Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...The MSBU also conducts proactive outreach to customer groups to assist with education on important employer and member resources and value-added services. For employer plans to cover 1-4 enrolled employees, contact our dedicated Micro Small Business Team at 1-888-706-2957. Micro Small Business Unit FAQs. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans and the Centers for Medicare and Medicaid Services (CMS). Medicaid and FAMIS products are administered under an agreement with Sentara ... 1) Please select your plan: Sentara Community Plan: Medicaid for dates of service on or after 1/1/2024. (Cardinal Care) Sentara Medicare for dates of service on or after 1/1/2024. (Sentara MAPD, MA, D-SNP, C-SNP, Part B Give Back) Optima Community Care: OCC Medicaid for dates of service on or before 12/31/2023. (OHCC/FAMIS/Family Care) If you need answers to other questions or need to ask about a specific plan and benefits please call member services from 8 a.m. to 6 p.m. Monday through Friday at the phone number listed on the back of your member ID card. If you are not a member and need information about enrolling, call 757-552-7401. TTY lines for the hearing impaired are 711. Sentara Medicare is a service of Sentara Health, recognized as one of the nation’s top 15 highest-performing health systems by IBM Watson Health 2. As part of the Sentara system, Optima Health operates with the same mission—to improve health every day. 1Members with chronic condition (s) that meet certain criteria may be eligible for this ... Sentara Health Plans is part of the Sentara Healthcare integrated health care system. This system is made up of companies owned by Sentara Healthcare. In order to ensure uniformity throughout the system, every member of the Sentara Healthcare family, including Sentara Health Plans, must comply with the basic privacy principals found in the ... Sentara Health Plans is the new name of Optima Health, a trusted provider of healthcare services in Virginia and North Carolina. Learn how the name change …Thank you for choosing Sentara Health Plans. We are excited to serve the employees and family members of the City of Newport News. We encourage you to take some time to explore the plans and resources available to you as a Sentara Health Plans member. 2024 Benefits. Access plan documents and benefits information. Health and Wellness. …All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans and the Centers for Medicare and Medicaid Services (CMS). Medicaid and FAMIS products are administered under an agreement … With Sentara Medicare, you'll get medical and prescription drug coverage – all in one plan. A Medicare Advantage plan with Sentara Health Plans provides more robust coverage than Original Medicare, plus $0 premiums and predictable out-of-pocket costs to budget for your healthcare needs. To learn about your plan, talk to one of our Sentara Individual & Family Health Plan Advisors at 1-844-206-3208. Find the Right Plan for You. Learn the differences between open enrollment period and special enrollment period, including how to handle life-changing events such as getting married, having a baby or getting divorced.Noticias; Publicado: 2018-07-12 07:56:45 Visto 3705 veces; Buenaventura, 12 de julio de 2018. En reunión sostenida entre la Secretaría de Salud del Distrito y los representantes …Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara … With Sentara Medicare, you'll get medical and prescription drug coverage – all in one plan. A Medicare Advantage plan with Sentara Health Plans provides more robust coverage than Original Medicare, plus $0 premiums and predictable out-of-pocket costs to budget for your healthcare needs. Provider Directories. As of January 1, 2023, Virginia's Medicaid program is now rebranded to Cardinal Care. This program provides all healthcare coverage for Medicaid members under one brand. To support this, our provider directories for Medallion 4 and CCC+ have been combined. The updated directory is now available. To find out more about ... Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Aquí nos gustaría mostrarte una descripción, pero el sitio web que estás mirando no lo permite.Sign In. The resources listed here are intended for providers associated with Sentara Community Plan, the plan formerly known as Virginia Premier. If you forgot your username or need help with your password, call 1-877-814-9909 or email [email protected] Vision Correction Discounts. Health plan members are eligible to receive up to a 15 percent discount off the cost of LASIK laser surgery (or five percent off a promotional price if lower). If you are interested in LASIK surgery, call 1-888-705-2020 to select a participating provider. * Some Pearle Vision franchises do not participate.Sentara Health Plans is committed to providing members with quality, cost-effective healthcare. Whether you’re choosing a health insurance plan for your employees or your family, we are confident you will find coverage that is right for you. Learn more. SEN-1051-EarnItHere-59.jpg.jpeg.Sentara Medicare is a service of Sentara Health, recognized as one of the nation’s top 15 highest-performing health systems by IBM Watson Health 2. As part of the Sentara system, Optima Health operates with the same mission—to improve health every day. 1Members with chronic condition (s) that meet certain criteria may be eligible for this ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Dear Provider, In the past few months, Sentara Health Plans has implemented several system changes to improve the way we do business with you as a provider. We …Sentara Healthcare invests nearly $4 million in two new pipeline development programs to support students pursuing healthcare careers Sentara Community Care Achievements Sentara Community Care achieves measurable results in 2022, plans to expand across the Commonwealth in 2023Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ...Aquí nos gustaría mostrarte una descripción, pero el sitio web que estás mirando no lo permite.Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara … Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ... Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ... NEW Partial D-SNP: Sentara Community Complete Select (HMO D-SNP) If you are only partial dual eligible, you may qualify for some Extra Help, even if you don’t qualify for full benefits through Virginia Medicaid. Sentara Community Complete Select may be the plan for you. To see if you qualify, call a Licensed Plan Advisor at 1-855-434-3267 ... 1) Please select your plan: Sentara Community Plan: Medicaid for dates of service on or after 1/1/2024. (Cardinal Care) Sentara Medicare for dates of service on or after 1/1/2024. (Sentara MAPD, MA, D-SNP, C-SNP, Part B Give Back) Optima Community Care: OCC Medicaid for dates of service on or before 12/31/2023. (OHCC/FAMIS/Family Care) Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...That makes Anthem and Sentara health plans direct competitors for some of the same customers. Anthem argued that it gives the health system an added incentive to terminate Anthem’s coverage. When that type of disruption occurs, the Department of Medical Assistance Services allows Medicaid members to switch health plans outside …Colin Drozdowski is President of Sentara Health Plans (SHP) and an Executive Vice President of Sentara. Through its two health plans, Optima Health and Virginia Premier, SHP serves more than 950,000 members and partners with more than 100 hospitals and 25,000 physicians. Colin is responsible for the strategic direction, performance and …Sentara Health Plans offers a variety of tools to ensure you make the most of every health care dollar. You can look up medications covered by the plan, get cost estimates for those drugs, or search network pharmacies. To make the most of these tools, we recommend that you sign in to access your secure, personalized information, especially if ...2 Certain preventive care services and medications for individuals covered by an Sentara Health Plans insurance plan are available at no charge when administered by an in-network physician or pharmacy. An office visit copayment may be charged to health plan members for some services. For members with a new or renewing health plan or policy ...Jan 8, 2024 · Sentara Health Plans offers individual health plan coverage that includes prescription benefits, wellness programs, preventive services, as well as useful tools to manage healthcare costs. Extra savings and discounts. Wellness and prevention programs: cancer screenings, women's wellness visits, and child wellness programs. Sentara Medicare is a service of Sentara Health, recognized as one of the nation’s top 15 highest-performing health systems by IBM Watson Health 2. As part of the Sentara system, Optima Health operates with the same mission—to improve health every day. 1Members with chronic condition (s) that meet certain criteria may be eligible for this ...Contact Us. For general inquiries, please contact us via the phone or email below. 757-687-6030 or 1-877-552-7401 (toll–free) [email protected]. Sentara Health Plans is the new name of Optima Health, a trusted provider of healthcare services in Virginia and North Carolina. Learn how the name change affects you, your doctors, your benefits, and your prescription medicine coverage. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ... Sentara Health Plans offers health coverage for groups, individuals, Medicaid, and Medicare in Virginia and Florida. It is part of Sentara Health, a not-for-profit health system with over 130 years of history and mission. Provider Directories. As of January 1, 2023, Virginia's Medicaid program is now rebranded to Cardinal Care. This program provides all healthcare coverage for Medicaid members under one brand. To support this, our provider directories for Medallion 4 and CCC+ have been combined. The updated directory is now available. To find out more about ... Request an enrollment kit. Schedule an appointment. Call a Licensed Plan Advisor at 1-855-434-3267 (TTY: 711) Updated: September 30, 2023. Sentara Medicare HMO members have access to an extensive network of doctors. Find out if …Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara …Enjoy a new look and exciting features of our provider search tool! Search for primary care providers that are in-network and accepting new patients all at a glance. Learn more about these new features. Sentara Health Plans offers tools to help you find doctors, health care facilities, drugs and medications that are part of your plan.The Sentara Health Plans Treatment Cost Calculator puts you in the driver’s seat — giving you more control to decide what works best for your health and your budget. You can save hundreds of dollars by shopping and comparing out-of-pocket expenses for common medical procedures and services.Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara …Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider. Offering hundreds of sites of care including 12 hospitals and multiple services that supports an 858,000-member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. Please mail your payment, along with the payment stub from your monthly bill, to P.O. Box 715892, Philadelphia, PA 19171-5892. Please note: your payment must be received by the last day of the month. Telephone. Call 757-687-6434 or 1-888-737-5479 and select option 2 to pay by phone with an Sentara Health Plans representative. As an Integrated Delivery Network (IDN) the change deepens the alignment between Sentara’s healthcare services and health plans. Sentara Health Plans will begin introducing the brand to the market this fall. In Virginia, all health plan members will receive Sentara Health Plans ID Cards around January 1, 2024.Contact Us. For general inquiries, please contact us via the phone or email below. 757-687-6030 or 1-877-552-7401 (toll–free) [email protected] for Use or Disclosure of Medical Information (Designated Representative) PDF, 115 KB Last Updated: 12/21/2023. PDF, 115 KB Last Updated: 12/21/2023. Find important documents and forms relating to your Sentara Family Care and Sentara Health Plans Community Care Medicaid plan.Jan 12, 2024 · We’re proud to offer Sentara Medicare – plans that give your clients everything Medicare offers plus some extra benefits and preventive services, including: $0 copay for personal doctor visits. $0 copay for many generic drugs. Dental, vision and hearing benefits. Over-the-counter allowance. Authorization for Use or Disclosure of Medical Information (Designated Representative) PDF, 115 KB Last Updated: 12/21/2023. PDF, 115 KB Last Updated: 12/21/2023. Find important documents and forms relating to your Sentara Family Care and Sentara Health Plans Community Care Medicaid plan.Cardinal Care Implementation. September 1, 2023, Sentara Health Plans will merge its Medallion 4.0 and CCC+ Medicaid programs under one new program and product name. This transition ensures alignment with statewide changes led by the Virginia Department of Medical Assistance Services (DMAS).Sentara Health Plans offers health insurance coverage to over 875,000 members in Virginia and North Carolina. It has a network of over 35,000 providers and employs clinical and non-clinical staff for member support …Sentara Health Plans provides health insurance coverage to over 875,000 members through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees. With more than 55 years of …Optima Health Code of Compliance. PDF, 143 KB Last Updated: 03/28/2023. PDF, 143 KB Last Updated: 03/28/2023. Access important Compliance documents.Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ... The Part B Giveback plan, Sentara Medicare Savings, reduces your SSA premium by $70. $0 monthly premium. Covers more than Original Medicare including many extras. Comprehensive formulary with prescription drug coverage including 30- to 100-day supplies and home delivery options. See if Sentara Medicare Savings is offered in your location. All Sentara Health Plans Medicare and Medicaid products require an active PaySpan Account. To start the PaySpan registration process, you may contact [email protected] or call 1-877-331-7154, option 1 to obtain the registration codes and assistance with navigating the website.Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...If you need answers to other questions or need to ask about a specific plan and benefits please call member services from 8 a.m. to 6 p.m. Monday through Friday at the phone number listed on the back of your member ID card. If you are not a member and need information about enrolling, call 757-552-7401. TTY lines for the hearing impaired are 711.Dear Provider, In the past few months, Sentara Health Plans has implemented several system changes to improve the way we do business with you as a provider. We …Sentara Health Plans offers health insurance coverage to over 875,000 members in Virginia and North Carolina. It has a network of over 35,000 providers and employs clinical and non-clinical staff for member support …Jan 12, 2024 · We’re proud to offer Sentara Medicare – plans that give your clients everything Medicare offers plus some extra benefits and preventive services, including: $0 copay for personal doctor visits. $0 copay for many generic drugs. Dental, vision and hearing benefits. Over-the-counter allowance. Sentara Health Plans Alternative Language Options for Notices and Other Written Information Amharic. ማሳሰቢያ፡ አማርኛ ቋንቋ የሚናገሩ ከሆነ፣ ከክፍያ ነጻ የሆነ የቋንቋ እገዛ አገልግሎት ይቀርብልዎታል፡፡ በዚህ ስልክ ይደውሉ 1-855-687-6260 (TTY: 711) ፡፡. ArabicSentara Health Plans offers health insurance plans for individuals, families, employers, Medicare, Medicaid and more. Learn about the new name, virtual care, discounts, wellness programs and COVID-19 resources.Sentara Health Plans offers health coverage for groups, individuals, Medicaid, and Medicare in Virginia and Florida. It is part of Sentara Health, a not-for-profit health …Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the …Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...Noticias; Publicado: 2018-07-12 07:56:45 Visto 3705 veces; Buenaventura, 12 de julio de 2018. En reunión sostenida entre la Secretaría de Salud del Distrito y los representantes …Sentara Health Plans is the new name of Optima Health, a trusted provider of healthcare services in Virginia and North Carolina. Learn how the name change …Key clinically integrated networks within the Sentara Health Plans provider network offer members the benefit of new models of care from a custom care team, to deliver the right care, in the right place, at the right time. 90.4% of providers would recommend Sentara Health Plans to family or friends 1) Please select your plan: Sentara Community Plan: Medicaid for dates of service on or after 1/1/2024. (Cardinal Care) Sentara Medicare for dates of service on or after 1/1/2024. (Sentara MAPD, MA, D-SNP, C-SNP, Part B Give Back) Optima Community Care: OCC Medicaid for dates of service on or before 12/31/2023. (OHCC/FAMIS/Family Care) A formulary is a list of covered drugs selected by Sentara Medicare in consultation with a team of health care providers, which represents the prescription therapies believed to be …Pharmacies that wish to be included in the Sentara Health Plans Specialty Pharmacy Network should contact Sentara Health Plans at 757-552-7474 or 1-800-229-8822. Limited Distribution Drugs (LDD) Some specialty drugs are limited distribution drugs (LDD), meaning only specific pharmacies can dispense the medication. In the event that …Find out which health insurance plans are accepted by Sentara hospitals and physicians. Learn about your financial responsibility, financial assistance and medical bill rights and …Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the … Medicaid Eligibility for Adults. Adults may be eligible if you: are a Virginia resident, age 19 to 64. are a United States citizen or lawfully-residing immigrant. are not eligible or covered by Medicare. you are medically complex. meet the income requirements based on your household size. You may be eligible for a Dual Special Needs Plan (D-SNP ... 2 Certain preventive care services and medications for individuals covered by an Sentara Health Plans insurance plan are available at no charge when administered by an in-network physician or pharmacy. An office visit copayment may be charged to health plan members for some services. For members with a new or renewing health plan or policy ...Sentara Medicare is a service of Sentara Health, recognized as one of the nation’s top 15 highest-performing health systems by IBM Watson Health 2. As part of the Sentara system, Optima Health operates with the same mission—to improve health every day. 1Members with chronic condition (s) that meet certain criteria may be eligible for this ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ...
Noticias; Publicado: 2018-07-12 07:56:45 Visto 3705 veces; Buenaventura, 12 de julio de 2018. En reunión sostenida entre la Secretaría de Salud del Distrito y los representantes …. Doctor on demand login
The Part B Giveback plan, Sentara Medicare Savings, reduces your SSA premium by $70. $0 monthly premium. Covers more than Original Medicare including many extras. Comprehensive formulary with prescription drug coverage including 30- to 100-day supplies and home delivery options. See if Sentara Medicare Savings is offered in your location. Jul 18, 2023 · Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ... Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara Health Plans ... Following the combination of the plans, Virginia Premier will not be a Medicaid plan option during open enrollment, but enrollees will be able to choose Optima Health for their Medicaid plan. In addition, Sentara Health Plans is guiding members through the Medicaid Eligibility redetermination effort following the end of the national Public ... If you need answers to other questions or need to ask about a specific plan and benefits please call member services from 8 a.m. to 6 p.m. Monday through Friday at the phone number listed on the back of your member ID card. If you are not a member and need information about enrolling, call 757-552-7401. TTY lines for the hearing impaired are 711.Preferred Provider Organization (PPO) products are issued and underwritten by Sentara Health Insurance Company. Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be ...Sentara Health Administration, Inc. provides administrative services to group and individual health plans but does not underwrite benefits. All plans have benefit exclusions and limitations and terms under which the policy may be continued in force or discontinued. Medicare products are administered under an agreement with Sentara …Sentara Health Plans is a trade name of Sentara Health Plans, Sentara Health Insurance Company, Sentara Health Administration, Inc., and Sentara Behavioral Health Services, Inc. To verify the member’s benefits with Sentara Health Plans, please call: 1-800-229-8822 for medical or 1-800-648-8420 for behavioral health. v.0923.Sentara Health Plans members should discuss the information in the medical policies with their treating health care professionals. Medical technology is constantly evolving, and these medical policies are subject to change without notice, although Sentara Health Plans will notify providers as required in advance of changes that could have a negative impact …Sentara Health Plans provides health insurance coverage to over 875,000 members through a full suite of commercial products including consumer-driven, employee-owned and employer-sponsored plans, individual and family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees. With more than 55 years of …That makes Anthem and Sentara health plans direct competitors for some of the same customers. Anthem argued that it gives the health system an added incentive to terminate Anthem’s coverage. When that type of disruption occurs, the Department of Medical Assistance Services allows Medicaid members to switch health plans outside …Authorization for Use or Disclosure of Medical Information (Designated Representative) PDF, 115 KB Last Updated: 12/21/2023. PDF, 115 KB Last Updated: 12/21/2023. Find important documents and forms relating to your Sentara Family Care and Sentara Health Plans Community Care Medicaid plan.Sentara Health Plans will not take punitive action against a provider who requests an expedited resolution or supports a member’s appeal. An urgent care claim is a claim for medical care treatment where using the standard Sentara Health Plans appeal procedure for making a decision would: (a) Seriously jeopardize the life or health of the member or ….