To report incorrect information, email provider_directory_invalid_issues@uhc.com. Learn more here. Your Long Term Care plan, Staywell Health Plan, is joining Sunshine Health. Newborns will be automatically enrolled in their mothers plan at the time of birth. 3. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs. All paperwork given to the Florida Department of Families and Children with the Medicaid application should be copies and not original documents. Call us: MMA: 1-888-716-8787 / TTY: 711 LTC: 1-800-791-9233 / TTY: 711 24 hours a day, 7 days a week If you're ready to join, or just want to know more call and speak to a Medicaid Choice Counselor toll free at 1-877-711-3662. Resources and Important Telephone Numbers, Electronic acknowledgment of claim receipt, Better turnaround time for timely reimbursement. Wellcare uses cookies. Please click on the links below to find out more about each plan, including benefits. UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. In addition to writing resubmitted on the claim, the additional/new information should be attached. Statewide Medicaid Managed Care (SMMC) provides the infoon the next page. Alachua, Visit the Agency for Health Care Administrations website where you can viewour health plans performance measure results and compare with those of other health plans. Important updates, PDF about our transportation services provider. Claims processing edits Claims coding Download claim coding and payment inquiry process guidelines. Florida Providers Home - Molina Healthcare Monday Friday, 8 a.m. 6 p.m., Eastern time, ModivCare Humana Medical Plan Inc. is a Managed Care Plan with a Florida Medicaid Contract. Choice Counselors are available at 1-877-711-3662 to answer your questions M-TH 8am-8pm, F 8am-7pm. Newborns will be automatically enrolled in their mothers plan at the time of birth. Medicaid. We value our partnership and are here to help. Enrollment in the plan depends on the plans contract renewal with Medicare. WellCare Health Plans The MMA Plan is available in the following counties: The Health & Home Connection SMMC LTC Program is available in the following counties: Eligible Medicaid recipients will receive a letter with enrollment information, including information on how to enroll. I understand that my information will be used in accordance with my plan notice of privacy practices. Find the contact information you need to get in touch. Change Healthcare Support Team can be contacted at 800-956-5190 Monday through Friday 8:00AM 5:00PM CST. Out-of-network/non- contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. The service is not an insurance program and may be discontinued at any time. Monday Friday, 8:30 a.m. 5 p.m., Eastern time, Expecting? In addition to writing corrected on the claim, the corrected information should be circled so that it can be identified. Please be aware that enrollment in Medicaid is not lifelong. Contact Us. Heres the good news: a simple shot can reduce your chances of getting influenza and its available to you at no cost with your UnitedHealthcare Community Plan. Billing and Claims | Sunshine Health Billing and Claims Please see the Provider Billing Manual and Billing Quick Reference Guides (QRGs). Call Florida's enrollment broker to enroll, disenroll, or ask questions: 1-877-711-3662 (TTY: 711). This partnership will better enable DOH's CMS Health Recipients will have to reapply for Medicaid every 12 months or another predetermined time period. Baker, Data rates may apply. Resource Center Medical plan coverage offered by: UnitedHealthcare of Arizona, Inc.; Rocky Mountain Health Maintenance Organization Incorporated in CO; UnitedHealthcare of Florida, Inc.; UnitedHealthcare of Georgia, Inc; UnitedHealthcare of Illinois, Inc.; UnitedHealthcare Insurance Company in AL, KS, LA, MO, and TN; Optimum Choice, Inc. in MD and VA; UnitedHealthcare Community Plan, Inc. in MI; UnitedHealthcare of Mississippi, Inc.; UnitedHealthcare of North Carolina, Inc.; UnitedHealthcare of Ohio, Inc.; UnitedHealthcare of Oklahoma, Inc.; UnitedHealthcare of Texas, Inc.; and UnitedHealthcare of Oregon, Inc. in WA. This is our provider claims submission portal via Change Healthcare (formerly known as Emdeon). Bradford, Download the free version of Adobe Reader. Sunshine Health is a . Look here at Medicaid.gov. UHC_Civil_Rights@uhc.com. It is funded by both the state and federal governments. If you dont have your account, create it today. Children's Medical Services Health Plan (KidCare), Complaints, Grievances and Appeals (Medicaid), Medicaid Supplemental Preferred Drug List, Pediatric Therapy Provider Access Contact, ROPA Provider Enrollment Application Now Available, Derrick Brooks and Sunshine Health encourage COVID-19 vaccinations, How to Create Positive New Habits in our New World, Ancillary MMA/SMI/CW Including Home Health, PDN (PDF, Ancillary CMS Including Home Health, PDN (PDF), Ancillary LTC Including Home Health, PDN (PDF), Assisted Living Facility MMA/SMI/CW (PDF), Early Intervention Services Providers (PDF), PIC:TFK Partners in Care Together for Kids (PDF), PPEC Prescribed Pediatric Extended Care (PDF). Floridas Medicaid program is called the Statewide Medicaid Managed Care (SMMC) Program. Your billing department will need to submit to the appropriate payer to prevent payment delays. Lake, Sumter, You must file claims within 180 days of the date you provided services, unless theres a contractual exception. Benefits, formulary, pharmacy network, premium and/or co-payments/ co-insurance may change. For paper claims, please submit to Vivida at the following address: Vivida Health Call Us. WellCareMedicare products,claims and correspondence proceduresare not changing at this time. If you need help with your complaint, please call the toll-free member phone number listed on your member ID card. Offer not available on the following items: photo orders, prescriptions, tobacco, dairy, alcohol, liquor departments, phone/prepaid/gift cards, money orders/transfers, transportation passes, lottery tickets, charitable donations, pseudoephedrine or ephedrine products, newspapers, magazines, stamps, home medical equipment and durable medical equipment products, pharmacy items and services, Prescriptions Savings Club membership fee, and items or services submitted to insurance for reimbursement or where otherwise limited by law. Phone 502-354-1364 Durable medical equipment and supplies fee schedule. Online: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, Mail: U.S. Dept. Petersburg Field Office 525 Mirror Lake Dr. N, Suite 510 St. Petersburg, FL 33701-3219 Attn: Out-of-State Exceptional Claims Each exceptional claim request submitted must include an individual letter on the providers letterhead, explaining the request for exceptional handling. Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Password Resets. Wellcare wants to ensure that claims are handled as efficiently as possible. SFLPEC-2446-21 February 2021 . Columbia, Print ID cards, chat with a nurse online, and more. Staywell Health Plans, Children's Medical Services Health Plans, Sunshine Health Plan, Childrens Medical Services Health Plan - Operated by Sunshine Health. Guidelines for proper claims submissions | Sunshine Health Enrollment in the plan depends on the plans contract renewal with Medicare. PDF Provider Billing Manual - Florida Medicaid & Health Insurance Region 1: Escambia, Okaloosa, Santa Rosa and Walton counties, Region 2: Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla and Washington counties, Region 3: Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union counties, Region 4: Baker, Clay, Duval, Flagler, Nassau, St. Johns and Volusia counties, Region 6: Hardee, Highlands, Hillsborough, Manatee and Polk counties, Region 7: Brevard, Orange, Osceola and Seminole counties, Region 8: Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota counties, Region 9: Indian River, Martin, Okeechobee, Palm Beach and St. Lucie counties, Region 11: Miami-Dade and Monroe counties. Petersburg Field Office 525 Mirror Lake Dr. N, Suite 510 St. Petersburg, FL 33701-3219 Attn: Out-of-State Exceptional Claims Each exceptional claim request submitted must include an individual letter on the provider's letterhead, explaining the request for exceptional handling. Humana Healthy Horizons in Florida members 6 months old and older can qualify to earn $20 in rewards through Go365 for Humana Healthy Horizons after getting a COVID-19 vaccine. Box 14165 Lexington, KY 40512-4165 In Puerto Rico, please use this address: Humana Inc. Unidad de Querellas y Apelaciones P.O. Create your enrollment by filling out the Provider Information, Contact Information, Bank Information (only if adding EFT enrollment(s)), and Enrollment Information. The Agency successfully completed the implementation of the Statewide Medicaid Managed Care (SMMC) program in 2014. Petitioners must complete the FL Medicaid application form properly as well as submit the required documents. You can find the billing codes you needfor specific servicesin the fee schedules. Your health information is kept confidential in accordance with the law. Or choose Go on to move forward. Virtual visits are not intended to address emergency or life-threatening medical conditions and should not be used in those circumstances. . Humana Medical Plan, PDF opens in new window - Multi-language Interpreter Services and formats, Humana Long-Term Care Plan, PDF opens in new window- Multi-language Interpreter Services and format. If billing a professional submission with services spanning before and after Oct. 1, 2021, please split the services into two separate claim submissions as outlined below. If you dont want to leaveyourstatesite, choose the X in the upper right corner to close this message.
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