Health Plan Directory by Region Revised 12-20-2017 aetna


Anthem For Health Plan Payor ID please contact your respective clearinghouse to obtain the correct ID - Professional-058916206CMSCOS



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Anthem

For Health Plan Payor ID please contact your respective clearinghouse to obtain the correct ID - Professional-058916206CMSCOS

DME AT and EM

Roanoke/Alleghany

Southwest

Northern/Winchester

Contracting


DME Contracting – application requests & submission
General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


Credentialing

General:


Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848
DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


Authorizations

General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483



General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


Claims

General:


Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848
DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


General:

Bernard Christmas, Ancillary Provider Relations Representative

Bernard.Christmas@anthem.com

(804) 354-2848


DME for Tech Waiver recipients and for children (on the tech waiver or not) receiving formula and catheters:

Andrea Peterson

Andrea.Peterson@anthem.com

(Mobile) 757-685-6994

(Fax) 855-626-6483


Care

Coordination





Virginia (Ginger) Lipes-540-235-4810

Virginia.lipes@anthem.com




Tonya McNulty-276-210-0256

Tonya.mcnulty@anthem.com




Adrianna Agnew-571-421-7876

Adriana.angew@anthem.com

Soon Denning-571-319-3445

Soon.denning@anthem.com

Precious Tembo-540-598-2406

Precious.tembo@anthem.com






MAGELLAN- Health Plan Payor ID: MCCVA updated 12/1/17

Nursing facility

Tidewater

Central

Charlottesville/Western

Contracting

Ciara Noble 757-407-7457
cnoble2@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Anthony Girgenti 480.243.5978
agirgenti@magellanhealth.com

Credentialing

Ciara Noble 757-407-7457
cnoble2@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Anthony Girgenti 480.243.5978
agirgenti@magellanhealth.com

Authorizations

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Claims

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Care Coordination

Cheryl Stoddard 804-658-7985
CStoddard@magellanhealth.com

Tracy Maitland-Martin 804-720-8082
TMaitlandMartin@magellanhealth.com

Cheryl Stoddard 804-658-7985
CStoddard@magellanhealth.com




Nursing facility

Roanoke/Alleghany

Southwest

Northern/Winchester

Contracting

Kenya Onley 804-366-6339 KCOnley@magellanhealth.com

Carrie Becker 314-387-5346
cabecker@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Credentialing

Kenya Onley 804-366-6339 KCOnley@magellanhealth.com

Carrie Becker 314-387-5346
cabecker@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Authorizations

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Claims


Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Care Coordination

Hope Myers 276-608-8424 
KHmyers@magellanhealth.com

Brandi Baldwin 276-254-1666 bbaldwin@magellanhealth.com

Nikki Reed-Countee 571-373-1785
TReedCountee@magellanhealth.com



MAGELLAN- Health Plan Payor ID: MCCVA updated 12/1/17

Hospice__Tidewater__Central'>Hospice

Tidewater

Central

Charlottesville/Western

Contracting

Ciara Noble 757-407-7457
cnoble2@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Anthony Girgenti 480.243.5978
agirgenti@magellanhealth.com

Credentialing

Ciara Noble 757-407-7457
cnoble2@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Anthony Girgenti 480.243.5978
agirgenti@magellanhealth.com

Notifications- Authorizations

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Claims

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Care Coordination

Cheryl Stoddard 804-658-7985
CStoddard@magellanhealth.com

Tracy Maitland-Martin 804-720-8082
TMaitlandMartin@magellanhealth.com

Cheryl Stoddard 804-658-7985
CStoddard@magellanhealth.com




Hospice

Roanoke/Alleghany

Southwest

Northern/Winchester

Contracting

Kenya Onley 804-366-6339
KCOnley@magellanhealth.com

Carrie Becker 314-387-5346
cabecker@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Credentialing

Kenya Onley 804-366-6339
KCOnley@magellanhealth.com

Carrie Becker 314-387-5346
cabecker@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Notifications -Authorizations

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Claims

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Care Coordination

Hope Myers 276-608-8424 
KHmyers@magellanhealth.com

Brandi Baldwin 276-254-1666 bbaldwin@magellanhealth.com

Nikki Reed-Countee 571-373-1785
TReedCountee@magellanhealth.com

MAGELLAN- Health Plan Payor ID: MCCVA updated 12/1/17



LTSS

Tidewater

Central

Charlottesville/Western

Contracting

Ciara Noble 757-407-7457
cnoble2@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Anthony Girgenti 480-243-5978
agirgenti@magellanhealth.com

Credentialing

Ciara Noble 757-407-7457
cnoble2@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Anthony Girgenti 480-243-5978
agirgenti@magellanhealth.com

Authorizations

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Claims

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Care Coordination

Cheryl Stoddard 804-658-7985
CStoddard@magellanhealth.com

Tracy Maitland-Martin 804-720-8082
TMaitlandMartin@magellanhealth.com

Cheryl Stoddard 804-658-7985
CStoddard@magellanhealth.com




LTSS

Roanoke/Alleghany

Southwest

Northern/Winchester

Contracting

Kenya Onley 804-366-6339
KCOnley@magellanhealth.com

Carrie Becker 314-387-5346
cabecker@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Credentialing

Kenya Onley 804-366-6339
KCOnley@magellanhealth.com

Carrie Becker 314-387-5346
cabecker@magellanhealth.com

Kishwar Johnson 571-232-9127
Kijohnson4@magellanhealth.com

Authorizations

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Jamie Barton 804-762-6160
JBarton2@magellanhealth.com

Claims

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Kristine Brady 314-387-4935
kbrady1@magellanhealth.com

Care Coordination

Hope Myers 276-608-8424 
KHmyers@magellanhealth.com

Brandi Baldwin 276-254-1666 bbaldwin@magellanhealth.com

Nikki Reed-Countee 571-373-1785
TReedCountee@magellanhealth.com



MAGELLAN- Health Plan Payor ID: MCCVA updated 12/1/17

Community Mental Health Rehabilitation Services

Tidewater

Central

Charlottesville/Western

Contracting

Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Credentialing

Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com



Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Authorizations

Jamie Barton 804-762-6160

JBarton2@magellanhealth.com



Jamie Barton 804-762-6160

JBarton2@magellanhealth.com



Jamie Barton 804-762-6160

JBarton2@magellanhealth.com



Claims

Kristine Brady           314-387-4935
kbrady1@magellanhealth.com

Kristine Brady               314-387-4935
kbrady1@magellanhealth.com

Kristine Brady               314-387-4935
kbrady1@magellanhealth.com

Care Coordination

Cheryl Stoddard 804-658-7985
CStoddard@magellanhealth.com

Tracy Maitland-Martin 804-720-8082

TMaitlandMartin@magellanhealth.com



Cheryl Stoddard 804-658-7985

CStoddard@magellanhealth.com




Community Mental Health Rehabilitation Services

Roanoke/Alleghany

Southwest

Northern/Winchester

Contracting

Danyelle Smilovich   804-823-5076

ddsmilovich@magellanhealth.com




Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Credentialing

Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Danyelle Smilovich  804-823-5076

ddsmilovich@magellanhealth.com




Authorizations

Jamie Barton 804-762-6160

JBarton2@magellanhealth.com



Jamie Barton 804-762-6160

JBarton2@magellanhealth.com



Jamie Barton 804-762-6160

JBarton2@magellanhealth.com



Claims

Kristine Brady               314-387-4935
kbrady1@magellanhealth.com

Kristine Brady               314-387-4935
kbrady1@magellanhealth.com

Kristine Brady               314-387-4935
kbrady1@magellanhealth.com

Care Coordination

Hope Myers 276-608-8424 
KHmyers@magellanhealth.com

Brandi Baldwin 276-254-1666 bbaldwin@magellanhealth.com

Nikki Reed-Countee 571-373-1785
TReedCountee@magellanhealth.com


MAGELLAN- Health Plan Payer ID: MCCVA added 12/6/17

DME AT and EM

Tidewater

Central

Charlottesville/Western

Contracting

Ciara Noble                                 757-407-7457

cnoble2@magellanhealth.com

 


Kishwar Johnson                         571-232-9127

Kijohnson4@magellanhealth.com



Kenya Onley                                804-366-6339

KCOnley@magellanhealth.com



Credentialing

Ciara Noble                                757-407-7457

cnoble2@magellanhealth.com



Kishwar Johnson                          571-232-9127

Kijohnson4@magellanhealth.com



Anthony Girgenti                              480.243.5978

agirgenti@magellanhealth.com



Authorizations

Jamie Barton                       804-762-6160

JBarton2@magellanhealth.com

 

 


Jamie Barton                              804-762-6160

JBarton2@magellanhealth.com



Jamie Barton                              804-762-6160

JBarton2@magellanhealth.com



Claims

Kristine Brady                             314-387-4935

kbrady1@magellanhealth.com



Kristine Brady                             314-387-4935

kbrady1@magellanhealth.com



Kristine Brady                             314-387-4935

kbrady1@magellanhealth.com



Care Coordination

Cheryl Stoddard                    804-658-7985                          

CStoddard@magellanhealth.com



Tracy Maitland-Martin              804-720-8082                          

TMaitlandMartin@magellanhealth.com



Cheryl Stoddard                    804-658-7985                          

CStoddard@magellanhealth.com



Continued below



MAGELLAN- Health Plan Payer ID: MCCVA added 12/6/17

DME AT and EM

Roanoke/Alleghany

Southwest

Northern/Winchester

Contracting

Kenya Onley                         804-366-6339

KCOnley@magellanhealth.com



 Kenya Onley                                804-366-6339

KCOnley@magellanhealth.com



Kishwar Johnson                          571-232-9127

Kijohnson4@magellanhealth.com



Credentialing

Kenya Onley                         804-366-6339

KCOnley@magellanhealth.com



Carrie Becker                              314-387-5346

cabecker@magellanhealth.com



Carrie Becker                            314-387-5346

cabecker@magellanhealth.com



Authorizations

Jamie Barton                           804-762-6160

JBarton2@magellanhealth.com

 


Jamie Barton                               804-762-6160

JBarton2@magellanhealth.com



Jamie Barton                               804-762-6160

JBarton2@magellanhealth.com



Claims

Kristine Brady                            314-387-4935

kbrady1@magellanhealth.com



 Kristine Brady                           314-387-4935

kbrady1@magellanhealth.com



Kristine Brady                             314-387-4935

kbrady1@magellanhealth.com



Care Coordination

Hope Myers                          276-608-8424

KHmyers@magellanhealth.com         



 Brandi Baldwin                          276-254-1666 bbaldwin@magellanhealth.com  

Nikki Reed-Countee          571-373-1785

TReedCountee@magellanhealth.com




OPTIMA Updated 11/6/17

Health Plan Payer ID: Institutional: 00453/ Professional: 54154/ Professional Mental Health: 5415M





Nursing Facility

Tidewater

Central

Charlottesville/Western

Contracting

Kresha Garland                          757-983-4010

krgarland@sentara.com



Deborah Abbey-Bada                    757-983-9671

mdabbeyb@sentara.com



Didi France                                        540-562-8236

dafranc1@sentara.com



Credentialing

Linda Winebrenner 757-687-6333
LKWINEBR@sentara.com

Linda Winebrenner 757-687-6333
LKWINEBR@sentara.com

Linda Winebrenner 757-687-6333
LKWINEBR@sentara.com

Authorizations

Erna Tegreeny                           757-983-4028

extegree@sentara.com



Erna Tegreeny                            757-983-4028

extegree@sentara.com



Erna Tegreeny                           757-983-4028

extegree@sentara.com



Claims

Primary:  Louis Mineor        757-983-4007
LLMINEOR@sentara.com
Secondary:  Mark Cotton     757-983-4005
MSCOTTON@sentara.com

Primary:  Louis Mineor         757-983-4007
LLMINEOR@sentara.com
Secondary:  Mark Cotton      757-983-4005
MSCOTTON@sentara.com

Primary:  Louis Mineor         757-983-4007
LLMINEOR@sentara.com
Secondary:  Mark Cotton     757-983-4005
MSCOTTON@sentara.com

Care Coordination

Latosha Goldsmith                 757-983-4019

llgoldsm@sentara.com



Carol Obi-Washington          804-510-7572

cxobiwas@sentara.com



Kennedy Barbour                    757-983-4027

kxbarbou@sentara.com






Nursing Facility

Roanoke/Alleghany

Southwest

Northern/Winchester

Contracting

Didi France                               540-562-8236

dafranc1@sentara.com



Didi France                               540-562-8236

dafranc1@sentara.com



Deborah Abbey-Bada                    757-983-9671

mdabbeyb@sentara.com



Credentialing

Linda Winebrenner                   757-687-6333
LKWINEBR@sentara.com

Linda Winebrenner                        757-687-6333
LKWINEBR@sentara.com

Linda Winebrenner                         757-687-6333
LKWINEBR@sentara.com

Authorizations

Erna Tegreeny                           757-983-4028

extegree@sentara.com



Erna Tegreeny                           757-983-4028

extegree@sentara.com



Erna Tegreeny                           757-983-4028

extegree@sentara.com



Claims

Primary:  Louis Mineor         757-983-4007
LLMINEOR@sentara.com
Secondary:  Mark Cotton     757-983-4005
MSCOTTON@sentara.com

Primary:  Louis Mineor        757-983-4007
LLMINEOR@sentara.com
Secondary:  Mark Cotton     757-983-4005
MSCOTTON@sentara.com

Primary:  Louis Mineor        757-983-4007
LLMINEOR@sentara.com
Secondary:  Mark Cotton     757-983-4005
MSCOTTON@sentara.com

Care Coordination

Jamie Gautier                        757-807-0927

jxpruitt@sentara.com



Jamie Gautier                        757-807-0927

jxpruitt@sentara.com



Carol Obi-Washington           804-510-7572

cxobiwas@sentara.com



OPTIMA Updated 11/6/17

Health Plan Payer ID: Institutional: 00453/ Professional: 54154/ Professional Mental Health: 5415M




Hospice

Tidewater

Central

Charlottesville/Western

Contracting

Kresha Garland                          757-983-4010

krgarland@sentara.com



Deborah Abbey-Bada                    757-983-9671

mdabbeyb@sentara.com



Didi France                                        540-562-8236

dafranc1@sentara.com



Credentialing

Linda Winebrenner                   757-687-6333
LKWINEBR@sentara.com

Linda Winebrenner                        757-687-6333
LKWINEBR@sentara.com

Linda Winebrenner                          757-687-6333
LKWINEBR@sentara.com

Notifications-Authorizations

Erna Tegreeny                           757-983-4028

extegree@sentara.com



Erna Tegreeny                           757-983-4028

extegree@sentara.com



Erna Tegreeny                           757-983-4028

extegree@sentara.com



Claims

Primary:  Louis Mineor        757-983-4007
LLMINEOR@sentara.com
Secondary:  Mark Cotton     757-983-4005
MSCOTTON@sentara.com

Primary:  Louis Mineor        757-983-4007
LLMINEOR@sentara.com
Secondary:  Mark Cotton     757-983-4005
MSCOTTON@sentara.com

Primary:  Louis Mineor        757-983-4007
LLMINEOR@sentara.com
Secondary:  Mark Cotton     757-983-4005
MSCOTTON@sentara.com

Care Coordination

Latosha Goldsmith                 757-983-4019

llgoldsm@sentara.com



Carol Obi-Washington          804-510-7572

cxobiwas@sentara.com



Kennedy Barbour                    757-983-4027

kxbarbou@sentara.com



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