Medical Billing Built for Virginia Healthcare Providers
Virginia consolidated its Medicaid managed care system into a single program called Cardinal Care, rebranding in January 2023 and fully merging what had been two separate programs — Medallion 4.0 and Commonwealth Coordinated Care Plus — into one managed care contract effective October 1, 2023. Cardinal Care is delivered through MCOs including Anthem HealthKeepers Plus, Sentara Health Plans (the 2023–24 rebrand of Optima Health, after it absorbed Virginia Premier's Medicaid membership), Molina Healthcare, UnitedHealthcare Community Plan, and Aetna Better Health of Virginia. Virginia expanded Medicaid effective January 1, 2019. Virginia also has a real, specific balance-billing law — SB 172 / HB 1251, signed in April 2020 — that protects patients from surprise bills for emergency care and certain out-of-network services at in-network facilities and instead routes the payment dispute to a payer-provider arbitration process through the State Corporation Commission, rather than the patient's bill.
Whether you're in Virginia Beach, Norfolk, Chesapeake or anywhere else in Virginia — ZenoMedix RCM provides the same certified billing expertise with deep knowledge of local payer rules and Virginia Medicaid requirements.
Major Payers We Work With in Virginia
Virginia Medicaid
Cardinal Care — Virginia's Medicaid managed care program, consolidated from the former Medallion 4.0 and CCC Plus programs effective October 1, 2023, delivered through Anthem HealthKeepers Plus, Sentara Health Plans, Molina Healthcare, UnitedHealthcare Community Plan, and Aetna Better Health of Virginia. Virginia expanded Medicaid on January 1, 2019.
HIPAA Compliance
Full HIPAA compliance for all VA providers. We stay current with all Virginia billing regulations. View HIPAA Statement →
Every City in Virginia — We're Your Billing Team
Remote billing means you get the same expert service whether you're in a major metro or a smaller community across Virginia.
75+ Specialties Served Across Virginia
Each specialty has a dedicated billing team trained on its CPT codes, modifiers, and payer-specific requirements in Virginia.
Everything Your Practice Needs — Nothing You Don't
Virginia Billing FAQ
Yes. Virginia consolidated Medallion 4.0 and Commonwealth Coordinated Care Plus into a single Cardinal Care managed care contract effective October 1, 2023. We bill under the current Cardinal Care structure and MCO assignment rather than the legacy program names.
It can. Under SB 172 / HB 1251, patients generally can't be balance-billed for emergency care or certain out-of-network services performed at an in-network facility — the payment dispute instead goes to arbitration between the payer and provider through the State Corporation Commission. We build claims and appeals around that process rather than defaulting to patient balance billing.
Yes. Optima Health — which had already absorbed Virginia Premier's Medicaid membership in 2023 — was rebranded as Sentara Health Plans starting in late 2023/2024. Our Virginia coding team bills it under its current name alongside Anthem HealthKeepers Plus, Kaiser Permanente, Aetna, and Cigna.
Most Virginia practices are fully onboarded and submitting live claims within 48 hours of signing. We're month-to-month — no long-term contract — and we work your existing claims backlog into the transition so nothing falls through.
We serve Virginia practices statewide, from Virginia Beach, Norfolk, Chesapeake, Richmond, and everywhere in between — not just the biggest metro area.