Oncology Program

OncoHealth administers the Sentara Health Plans (SHP) Oncology Benefits Management Program. The program includes support for prior authorization management of all SHP commercial, Medicaid and Medicare lines of business for members with a cancer diagnosis that requires chemotherapeutic drugs [oral and infusion], symptom management drugs, supportive agents, radiation therapy drugs, and molecular genetic testing.

Learn more about OncoHealth

Advance Care Planning

Sentara Health and the Sentara Center for Healthcare Ethics are offering the community the opportunity to complete their Advance Care Plan (Advance Directive) and register it, free of charge, with our national Advance Directive Registry through the U.S. Living Will Registry.

Advance Care Planning Guides

Avoidance of Antibiotic Use

Avoidance of antibiotic use focuses on ensuring antibiotics are only used for diagnosed or highly suspected bacterial infections.  

Avoidance of Antibiotic Use

Laboratory Benefit Management

Avalon provides Routine Testing Management (RTM) services to Sentara Health Plans through automated review of high-volume, low-cost laboratory tests.

Laboratory Benefit Management

Pediatric Obesity Prevention and Treatment Toolkit

Resources regarding health coaching, growth measurement tools, clinical guidelines, medically based programs, and more.

View the Toolkit

Care Management

Genetic Testing Management Program

The Genetic Testing Management (GTM) program, executed in partnership with Avalon, includes new and revised medical policies, a new authorization request process, guidelines, and consistent preservice reviews for certain genetic testing services that will be applicable to both ordering and rendering provider partners.

Avalon focuses on provider education both pre- and post-determination. Avalon reviews for medical necessity and focuses on correct coding by reviewing if the code appropriately represents the test being requested. If not, we attempt to educate the providers on those components. By combining both review processes, medical necessity, and coding—we will ensure that the correct service is identified and determined to be clinically appropriate according to evidence-based specialty lab guidelines and best practices. Learn more.

Optum Managed Transplant Program

Sentara Health Plans will utilize Optum’s Managed Transplant Program (MTP) of care management services for all organ and blood/marrow transplants for Sentara Health Plans Commercial plans. The transplant network will consist of Optum’s Centers of Excellence Facilities, Children’s Hospital of the King’s Daughters, Sentara Norfolk General Hospital, and Virginia Oncology Associates only. 

Tobacco Cessation Programs

Support your patients in quitting tobacco with Stay Smokeless for Life — a free, evidence-based cessation program. Eligible members receive access to a video library and toolkit designed to support long-term success.

Refer to tobacco cessation program details