florida medicaid provider master list
Category : 3 arena covid restrictions
NPI Registration Form: The NPI Registration Form will be discontinued with the following exceptions: NPI to Medicaid ID Search Engine: The existing tool will be enhanced and will be accessible via the secure Web Portal. It must be used in conjunction with the Florida Medicaid Provider Reimbursement Handbook, CMS-1500, which contains information about specific procedures for submitting claims for payment, and the Florida Medicaid Provider General Handbook, which describes the Florida Medicaid program. Sunshine Health is a managed care plan with a Florida Medicaid contract. 0000048907 00000 n Fill out the Statewide Medicaid Managed Care Registered Provider Initiative form (PDF) and submit it to: medicaideligibilityoutreach@ahca.myflorida.com. Email Advisory | 0000041970 00000 n 0000020302 00000 n For more information on the supplemental wage agreement and fee schedule increases related to the minimum wage requirements, please visit the Agencys Medicaid Provider Minimum Wage Requirements page on the Agencys website or visit the Supplemental Wage Agreement page under Agency initiatives on the public Web Portal. 304 0 obj <>stream [q@R[Chu$%ZYy+zYY-R4ihlrQu-nKdq:T,dhMq)u"8,RG6~]YBgFAsA OAzcV!"bJHJ. 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. E I IW42@ Va~(i&^ L ,d(SJ{K"K7(52jT^FT,48P$1XT4k8e. 2023 UnitedHealthcare | All Rights Reserved, Florida Medicaid: Claim and AHCA data must match, Sign in to the UnitedHealthcare Provider Portal, Health plans, policies, protocols and guides, The UnitedHealthcare Provider Portal resources, Verify your provider enrollment information as it appears on file with AHCA. Providers will see multiple changes to the Web Portal over the next few months regarding NPI Crosswalk. Agency for Health Care Administration; P.O. Florida Medicaid. In order for your Medicaid ID to remain active, you must update your enrollment type to Enrolled or Limited Enrollment by the PML expiration date. Managed Care Plan with a Florida Medicaid contract. No records found. V>*Iw!G2BtEfg]"g3z,6hmqI B.o`]])mohc/toB;*hAVygVwr =u%30Nb\\Byrp2" ;:RZ'd UEw%sJaP:|Jmf\SH)/)F(1NuUxz(`5Yc|H( eF]W)` 7GI\3@b1N+pZ4+LCFHdM$|a-OT,64M"7QweyFfZBy?krn,Qa2/~ZUs'Yic?bfD!|4uY@>6.ePcG2-$(+^#Kq]ZC$S4F. 3 0 obj Use the following chart to know whats needed to correct your claim based on the remittance denial code and go to our Claims Interactive Guide for instructions on how to submit a claim correction. CMS has streamlined regulatory requirements to help simplify DMEPOS payment requirements and reduce provider and supplier burden. PLEASE CHECK SPELLING, SPACING, ATTENDING SERVICE ADDRESS IS INVALID- . Providers can search for all Medicaid IDs associated to an NPI without having to navigate away from their secure account to use other resources to find this information. If the provider is a fully enrolled Medicaid provider (noted with "N" under Registered Provider column on Provider Master List) please contact AHCA at: 1-800-289-7799 Option 4. ii. Limitations, co-payments and restrictions may apply. Change of Address (COA) Wizard: The current COA Wizard will be enhanced to allow Individual providers (Entity Type 1) to add additional service location addresses to their existing files. Please contact the Public Records office for questions about the public records requests. Choice Counselors are available at 1-877-711-3662 to answer your questions M-TH 8am-8pm, F 8am-7pm. Limitations, co-payments and restrictions may apply. The Agency will implement the revised PML and PPL formats on February 25th, 2022. from pg. Statewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services. On the Florida Medicaid Web Portal you can access the Provider Master List. This page contains important information for providing continued services to displaced Florida Medicaid recipients impacted by Hurricane Ian. 0000013101 00000 n Providers participating in a Florida Medicaid managed care plan are federally required to enroll in Florida Medicaid. hbbd```b``A$"Y &$3&8d SIt+ Providers can submit claim status inquiries via the Medicare Administrative Contractors' provider Internet . To become a Medicare provider and file Medicare claims, you must first enroll in the Medicare program. 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. The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. Health Plan Portal User Manual. Example: ME99999 or ME069999. . AHCA requires that every provider who participates with Medicaid or CHIP beneficiaries maintain an active status on their Medicaid ID. Claims with a From Date of Service of March 1, 2022, or after should use the ZIP+4 associated with the provider service location address. 786 0 obj <> endobj 0000015958 00000 n %PDF-1.4 % Community Care Plan is owned by South Florida's most experienced names in health care: Broward Health (North Broward Hospital District) and Memorial Healthcare System (South Broward Hospital District). Download the free version of Adobe Reader. Take the following steps to ensure your information is accurate and matches the data recorded with AHCA and UnitedHealthcare Community Plan: Resubmitting denied claims COMMERCIAL, SELF-INSURED EMPLOYEE HEALTH PLANS. Closure, 835 | Florida Medicaid Web Portal (flmmis.com), healthplan.support@gainwelltechnologies.com, Medicaid Provider Minimum Wage Requirements page, Florida Medicaid Agency for Health Care Administration, Florida Medicaid Health Information Network, Florida Medicaid Health Care Alerts Subscription, Centers for Medicare and Medicaid Services (CMS), Florida Health Finder - Consumer Information, You are using a browser that does not support the features required for use with this web application (JavaScript not enabled). An updated Provider Master List tip sheet is now available on the Managed Care Support section of the 0000001036 00000 n website belongs to an official government organization in the United States. To access the tool, login to the secure Web Portal by clicking the Secure Web Portal Login button above. Only eligible enrolled Organizational (Group) providers operating under the same Federal Employer Identification Number (FEIN/Tax ID), may enroll additional service locations. 0000019453 00000 n The Freedom First Budget provided over $600 million in funding to the Agency for Health Care Administration (Agency or AHCA) for the sole purpose of increasing the minimum wage for employees of Medicaid providers to at least $15.00 an hour. Complete one or more search fields. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. For additional assistance, please contact Provider Enrollment at 1-800-289-7799, Option 4. The Recipient Procedure Lookup is available from the Claims menu or the Eligibility menu. Child Welfare Provider Directory - Region 3 (PDF) Serving Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union counties Child Welfare Provider Directory - Region 4 (PDF) Serving Baker, Clay, Duval, Flagler, Nassau, St. Johns and Volusia counties Default Pay Multiple Service Locations, Referring We maintain and annually update a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), which identifies all the items and services included within certain designated health services (DHS) categories or that may qualify for certain exceptions. If you would like to receive information regarding providers that were sanctioned by the Agency prior to July 1, 2009, please contact our Public Records Office at (850) 412-3688. 2023 Accurate Biometrics, Inc. | All rights reserved. To enroll, you must have an NPI. Date: 10/31/22. Please review the Holiday Office 826 0 obj <>stream Please review the Known Issues and Informational Items List for details listed related to the MMIS. 1 0 obj On February 2, 2022, the Agency for Health Care Administration (Agency), along with its fiscal agent Gainwell Technologies (Gainwell), sent an alert informing health plans of new CARC/RARC combinations that will post and deny on Health Plans 835 transactions containing encounters. INVALID, REFERRING 2 ZIP CODE IS MISSING/ Please visit the Hurricane Preparedness page frequently to remain up-to-date with the latest information as it is made available. (Use fewer fields to produce more results: See Search Help), Privacy Statement | Effective October 1, 2021, any fee-for-service claim submitted with a National Provider Identifier for a ROPA provider not enrolled with Florida Medicaid will be denied. INVALID- PLEASE CHECK SPELLING, SPACING, ORDERING SERVICE ADDRESS IS INVALID- Florida Medicaid Provider Reimbursement Handbook, CMS-1500 Illustration 1-1. lock The QRG Page has links to the NPI Self-Service Tool QRG, Address Maintenance Wizard QRG and other useful resources. The Agency has posted new NPI Crosswalk Enhancement guidance that is located on the AHCA public Web Portal under Agency Initiatives/NPI Crosswalk Enhancement. For more information, or to submit questions related to the new layout, please email the Health Plan Support team at: healthplan.support@gainwelltechnologies.com. means youve safely connected to the .gov website. If your Medicaid ID shows an enrollment type of Registered status on AHCAs Provider Master List (PML), claims received under your NPI will deny for Medicaid ineligibility. Additional information can be found in the NLC Quick Reference Guide (QRG), located in the Add Additional Locations section of the Enrollment Forms page. Updating NPI Crosswalk entity data (NPI, Taxonomy, and Zip+4) used for billing to fee-for-service claims or encounter submissions that include a date of service prior to March 1, 2022. The benefit information provided is a brief summary, not a complete description of benefits. Providers are encouraged to stay connected by visiting the Florida Medicaid Public Web Portal often for the most up-to-date information on these changes. <> D2 r1@&F9`00Ig` \ 268 0 obj <> endobj Master List of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items Potentially Subject to Conditions of Payment CMS has streamlined regulatory requirements to help simplify DMEPOS payment requirements and reduce provider and supplier burden. These enhancements will be available to Fully enrolled, Limited enrolled, and ROPA enrolled providers. 0000001251 00000 n Throughout this initiative, the Agency and Gainwell will keep the provider and health plan communities apprised of changes as they occur via Agency e-Alert notifications. 0000026201 00000 n Closure document for a comprehensive list of 2023 scheduled holidays. January 1, 2023, Humana Healthy Horizons in Florida (Medicaid) Preauthorization and Notification List January 1, 2023, Humana Healthy Horizons in Louisiana (Medicaid) Preauthorization and Notification List January 1, 2023, Humana Healthy Horizons in South Carolina (Medicaid) Preauthorization and Notification List Sunshine Health has the expertise to work with Medicaid and Long Term Care members to improve their health status and quality of life. For more information contact the Managed Care Plan. The new NPI to Medicaid ID Search Engine tool displays 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. For more information on these new self-service features, please visit the Quick Reference Guides (QRG) page of the Florida Medicaid public Web Portal, by navigating to Provider Services >> Training >> Quick Reference Guides. If you are a provider meeting the criteria above and currently have an Application Tracking Number (ATN), AHCAs Provider Enrollment team will assist you in completing the process. 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. ( The alphabetical listing of providers by specialty allows you to easily locate all the providers in the area that have the same scope of practice. 2 0 obj Procedure code lookups are now available on the Florida Medicaid Secure Web Portal via the new Recipient Procedure Lookup self-service tool. 0000074223 00000 n We recommend you use a certified browser to ensure that the application functions as expected. On June 2, 2022, Governor Ron DeSantis signed the Freedom First budget for State Fiscal Year (SFY) 2022-2023. INVALID, REFERRING SERVICE ADDRESS IS INVALID- Additional information can be found on the ROPA page, under the Agency Initiatives tab on the public Web Portal. Questions? The following new CARC/RARC combinations will pay and post on qualifying X12 837 encounters via 835 transactions when multiple provider IDs are matched to the submitted data: Billing hbbd```b``65 d3E`rX$LX$XDNL q%VV@&F`Jg-@ T Florida Medicaid will pay for medically necessary services provided to recipients diagnosed with COVID-19, regardless of whether the provider is located in-state or out-of-state. The new NPI self-service feature allows providers to update or add a new NPI to the Medicaid provider ID associated to the account the provider is logged into. Beginning October 8, 2021, a new self-service feature, the New Location Code (NLC) Wizard, will be available to eligible providers in the Florida Medicaid Secure Web Portal. 0000048276 00000 n Billing provider taxonomy missing or invalid on claim, Submit corrected claim with correct billing provider taxonomy, Rendering provider taxonomy missing or invalid on claim, Submit corrected claim with correct rendering provider taxonomy. Complete Enrollment for Your Medicaid ID. The interactive Provider Search Tool allows you to search for a quality health care provider in your area that is participating in the CMS Plan, including primary care physicians, hospitals, pharmacies and other health care professionals. The program has three parts: Managed Medical Assistance, Long-Term Care, and Dental. Use the, Verify your information matches what you submit on your claims. Medicaid Fair Hearing; An updated Provider Master List tip sheet is now available on the Managed Care Support section of the Florida Medicaid Web Portal that details the changes. By using this site, you agree to the Providers and health plans are encouraged to review the tip sheet to understand how the enhancement will affect their claims and/or encounter submissions. TIN - Tax ID Number . Detail Default Pay Multiple Service Locations, Ordering hb``Pd``e```a@@q%4IT$rfm@L!L!b)Cc[$00G2+_ w30Vif]%,Q o? endstream endobj 84 0 obj <>/Filter/FlateDecode/Index[5 44]/Length 20/Size 49/Type/XRef/W[1 1 1]>>stream 0000017333 00000 n Escambia, Okaloosa, Santa Rosa and Walton Counties, Bay, Calhoun, Gulf, Holmes, Jackson, Washington, Franklin, Gadsden, Jefferson, Leon, Liberty, Madison, Taylor and Wakulla Counties, Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy, Putnam, Suwannee, Citrus, Hernando, Lake, Marion, Sumter and Union Counties, Baker, Clay, Duval, Flagler, Nassau, Saint Johns and Volusia Counties, Hardee, Highlands, Polk, Manatee and Hillsborough Counties, Brevard, Orange, Osceola and Seminole Counties, Charlotte, DeSoto, Sarasota, Glades, Hendry, Lee and Collier Counties, Indian River, Martin, Okeechobee, St. Lucie and Palm Beach Counties, Annual Regulatory PlansFlorida Department of Health (pdf). This requirement also helps ensure we have the proper information needed to promptly pay your claims. https:// 0000017512 00000 n Providers have a number of options to obtain claim status information from Medicare Administrative Contractors (MACs): Providers can enter data via the Interactive Voice Response (IVR) telephone systems operated by the MACs. Search Providers | Florida Department of Health Home Programs & Services Infant, Child & Adolescent Health CMS Managed Care Plan Search Providers Search Providers CMS Plan 850-245-4200 CMSPlan@flhealth.gov Mailing Address Office of the CMS Managed Care Plan 4052 Bald Cypress Way, Bin A06 Tallahassee, FL 32399 hmo6 Humana Healthy Horizons in Florida is a Medicaid product of Humana Medical Plan Inc. LC17772FL0522 (FLHKCNLEN) Healthcare Provider Resource Guide - Statewide (Regions 1 through 11) Humana Healthy Horizons in Florida provider web page Your Humana Healthy Horizons in Florida provider website has a variety of materials and resources to help your Humana 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
