florida medicaid provider master list

The Agency for Health Care Administration (Agency) and the Agency's fiscal agent, Gainwell Technologies (Gainwell), have enacted the NPI Crosswalk Elimination initiative to mitigate NPI Crosswalk data issues. <> Health plans will be able to access the revised report layouts on the Registration page of the Florida Medicaid Web Portal. 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). AHCA will reopen ATNs for ALF providers who previously submitted an application that was terminated for incomplete documentation within the last six months. 0000001417 00000 n An official website of the United States government Online Form. Steps to getting contracted plus plan information, Phone numbers and links for connecting with us, List of contracted, high-quality independent lab providers, Update, verify and attest to your practice's demographic data, Provider search for doctors, clinics and facilities, plus dental and behavioral health, Policies for most plan types, plus protocols, guidelines and credentialing information, Specifically for Commercial and Medicare Advantage (MA) products, Pharmacy resources, tools, and references, Updates and getting started with our range of tools and programs, Reports and programs for operational efficiency and member support, Resources and support to prepare for and deliver care by telehealth, Tools, references and guides for supporting your practice, Log in for our suite of tools to assist you in caring for your patients. Download Provider File The information contained in this directory is made available to the public by the Illinois Department of Healthcare and Family Services (IDHFS) to assist Medical providers in verifying an actively enrolled ordering/referring/prescribing Medicaid provider. An updated Provider Master List tip sheet is now available on the Managed Care Support section of the COMMERCIAL, SELF-INSURED EMPLOYEE HEALTH PLANS. The Please visit the Hurricane Preparedness page on the public Web Portal under the Agency Initiatives tab. (cont. Provider Links - Florida 0000019074 00000 n For additional assistance, please contact Provider Enrollment at 1-800-289-7799, Option 4. Changes will impact the process for registering, validating, and correcting new and existing provider information. Providers can submit claim status inquiries via the Medicare Administrative Contractors' provider Internet . 521 '(6$17,6 *29(5125 0$5< & 0$<+(: 6(&5(7$5< +rph _ $erxw 8v _ 0hglfdlg _ /lfhqvxuh 5hjxodwlrq _ 5hsruw )udxg _ 5hsruw 0hglfdlg ,vvxh &rpsodlqw (Use fewer fields to produce more results: See Search Help), Privacy Statement | Transactions submitted with a From Date of Service of February 28, 2022, or earlier should use the taxonomy associated with the NPI Crosswalk. Email Us. The Enrollment Tracking Search feature has been updated to include application deficiency reasons. And to get an NPI, your application will need to include the taxonomy code that reflects your classification and specialization. Thank you for choosing the Children's Medical Services (CMS) Managed Care Plan for your health care needs. Medicaid & CHIP Enrollment Data. 0000001572 00000 n The process for provisional provider enrollment will be located on the New Medicaid Providers page, under the Provider Services menu. By using this site, you agree to the State Profiles | Medicaid 2023 UnitedHealthcare | All Rights Reserved, Florida Medicaid: Claim and AHCA data must match, Sign in to the UnitedHealthcare Provider Portal, Health plans, policies, protocols and guides, The UnitedHealthcare Provider Portal resources, Verify your provider enrollment information as it appears on file with AHCA. Need access to the UnitedHealthcare Provider Portal? There are three different programs that makeup the Statewide Medicaid Managed Care Managed Medical Assistance (MMA) Program, Long-term Care (LTC) Program, and Dental Program Learn More About MMA and LTC Learn More About Dental Use the, Verify your information matches what you submit on your claims. Privacy Policy. This impacted providers who had more than one state Medicaid ID. Some providers may not perform certain services based on religious or moral beliefs. The Recipient Procedure Lookup is available from the Claims menu or the Eligibility menu. hb``Pd``e```a@@q%4IT$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 0000026201 00000 n The agency will be posting related updates to X12 837 companion guides soon. 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 Florida State Medicaid Managed Care - Tab Window Title PDF NPI crosswalk logic change updates - Simply Healthcare Plans If the provider is not a fully enrolled provider (noted with "Y" under Registered Provider Column on Provider Master List) please contact WellCare at: 1-866-334- Florida Medicaid - Sign In Revised CMS-1500 Claim Form (front . 0000017512 00000 n Florida ORI Numbers and Professions - Accurate Biometrics Default Pay Multiple Service Locations, Other endobj No records found. For more information, or to submit questions related to the new layout, please email the Health Plan Support team at: healthplan.support@gainwelltechnologies.com. X Providers HCBS Incident Reporting System Medicaid Pharmacy Preferred Drug Lists Provider Forms Provider Types Public Notices . (Updated 02/15/2023). If you dont take action by your PML expiration date, you will be terminated from the Sunshine Health network on your PML expiration date. 0000020302 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. We can help. 0000048537 00000 n Closure document for a comprehensive list of 2023 scheduled holidays. Provider Directories | Florida Medicaid | Sunshine Health For more information contact the Managed Care Plan. | D61, Referring, Ordering, Prescribing, and Attending Providers, Known Issues and Informational Items List, Holiday Office The type and amount of services depends on the age of the beneficiary, the type of Medicaid program in which the beneficiary is enrolled, and the type of services determined medically necessary by the beneficiary's Primary Care Provider. PDF Florida Medicaid Health Care Alert - mytnfl.com PLEASE CHECK SPELLING, SPACING, ATTENDING SERVICE ADDRESS IS INVALID- To become a Medicare provider and file Medicare claims, you must first enroll in the Medicare program. website belongs to an official government organization in the United States. On the Florida Medicaid Web Portal you can access the Provider Master List. AHCA - Agency for Health Care Administration. Community Care Plan - Home - ccpcares Please note that a new browser window will open. 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. following taxonomy edits are not new but will continue to pay and Effective Nov. 1, 2022, if you submit claims with identifier information that doesnt match your provider enrollment data entered with the Agency for Health Care Administration (AHCA), your claims will be denied. 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. 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 0000041535 00000 n 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. 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. Florida Medicaid Providers & Health Insurance Plans | Sunshine Health Providers will see multiple changes to the Web Portal over the next few months regarding NPI Crosswalk. a. the Master Provider file (MPF), a Texas Medicaid and Healthcare Partnership (TMHP) data warehouse-derived pool of provider records, b. the TMHP member-facing directory or "online provider lookup" (OPL) on the TMHP website, c. the provider reconcile files, a MAXIMUS data warehouse-derived pool of provider records, and d.