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Florida Medicaid Providers & Health Insurance Plans | Sunshine Health See the Florida Medicaid Provider Registration Guidefor directions for successfully completing the form. | D61, Referring, Ordering, Prescribing, and Attending Providers, Known Issues and Informational Items List, Holiday Office Under the Managed Care menu, you will want to select Provider Master List, which can be found under the Registration column (third from the right). AHCA maintains a Provider Master List (PML) on their Managed Care site ( for providers and MCOs to download and view. 0000041995 00000 n List of CPT/HCPCS Codes | CMS - Centers for Medicare & Medicaid Services Health plans can access the sample test files with the new layout on the Submission Information page of the Florida Medicaid Web Portal. 0000026103 00000 n Secure .gov websites use HTTPSA This is done through the provision of quality services to meet the care needs of . endobj Business Name Enter Business Name for Establishments or Last Name for Practitioner Last Name First Name City County Zip Code License Status Privacy Policy. NPI to Medicaid ID Search Engine: The existing tool has been enhanced and is accessible via the secure Web Portal. Please review the Scheduled Maintenance AHCA will reopen ATNs for ALF providers who previously submitted an application that was terminated for incomplete documentation within the last six months. Provider Information Reports The Agency for Health Care Administration (Agency) provides three reports of provider data, the Provider Master List, the Pending Provider List, and the Denied Provider List. 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, MedicaidProvider Directory - Region 1 (PDF), MedicaidProvider Directory - Region 2 (PDF), MedicaidProvider Directory - Region 3 (PDF), MedicaidProvider Directory - Region 4 (PDF), MedicaidProvider Directory - Region 5 (PDF), MedicaidProvider Directory - Region 6 (PDF), MedicaidProvider Directory - Region 7 (PDF), MedicaidProvider Directory - Region 8 (PDF), MedicaidProvider Directory - Region 9 (PDF), MedicaidProvider Directory - Region 10 (PDF), MedicaidProvider Directory - Region 11 (PDF), Serving Escambia, Okaloosa, Santa Rosa and Walton counties, Serving Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla and Washington counties, Serving Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union counties, Serving Baker, Clay, Duval, Flagler, Nassau, St. Johns and Volusia counties, Serving Hardee, Highlands, Hillsborough, Manatee and Polk counties, Serving Brevard, Orange, Osceola and Seminole counties, Serving Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota counties, Serving Indian River, Martin, Okeechobee, Palm Beach and St. Lucie counties. code to match the state Provider Master List (PML). Revised CMS-1500 Claim Form (front . Completed and signed attestations can be submitted by the physician to the Department of Health via secure email at CMS.ClinicalEligibilityScreening@flhealth.gov or via fax to 850-488-3813. Florida Medicaid Provider Reimbursement Handbook, CMS-1500 Illustration 1-1. Choice Counselors are available at 1-877-711-3662 to answer your questions M-TH 8am-8pm, F 8am-7pm. *@ ?&ny`mk(>sUM'A{808+D5RtJ)NK'KL.pn& E|mH.kvzYE.=,-2u-Gpf! trailer <<9525EF5C7FA24921844CA5259BD404D3>]/Prev 78233/XRefStm 1251>> startxref 0 %%EOF 85 0 obj <>stream Some providers are called essential providers. They provide care to members statewide. endobj Claim submissions . 0000015958 00000 n (Updated 02/15/2023). ( An updated Provider Master List tip sheet is now available on the Managed Care Support section of the Florida Medicaid Web Portal that details the changes. For purpose of comparison, the table also presents (a) the change in enrollment since the initial open of the Health Insurance Marketplaces . The following essential providers are part of Sunshine Healths network and are available to all members: You will need Adobe Reader to open PDFs on this site. 0000019074 00000 n + 7B Providers will see multiple changes to the Web Portal over the next few months regarding NPI Crosswalk. 0000018945 00000 n They are located on the AHCA public web portal under Provider Services/EDI/Companion guides. Download the free version of Adobe Reader. The new NPI to Medicaid ID Search Engine tool will display an indicator to identify the Medicaid ID/service location that the NPI mapping logic will default to when there are multiple identical service locations for a single NPI. AHCA Find Medicaid Doctors, Dentists, and Specialists Find Medicaid Doctors, Dentists, and Specialists "To find doctors, dentists, and specialists in your community that serve Medicaid patients, go to www.flmedicaidmanagedcare.com or call 1-877-711-3662 to talk to a Choice Counselor." Provider Directories | Florida Medicaid | Sunshine Health Transactions submitted with a From Date of Service of February 28, 2022, or earlier should use the taxonomy associated with the NPI Crosswalk. Fort Lauderdale, Florida. PLEASE CHECK SPELLING, SPACING, REFERRING DETAIL SERVICE ADDRESS IS Take the following steps to ensure your information is accurate and matches the data recorded with AHCA and UnitedHealthcare Community Plan: Resubmitting denied claims hbbbd`b``* / endstream endobj 50 0 obj <>/Metadata 3 0 R/Pages 2 0 R/StructTreeRoot 5 0 R/Type/Catalog/ViewerPreferences<>>> endobj 51 0 obj >/PageTransformationMatrixList<0[1.0 0.0 0.0 1.0 0.0 -396.0]>>/PageUIDList<0 211>>/PageWidthList<0 612.0>>>>>>/Resources<>/ExtGState<>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 52 0 obj [/Separation/PANTONE#20Blue#20072#20CVC#201/DeviceCMYK<>] endobj 53 0 obj <>stream

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