florida medicaid provider master list

Medical Services Covered by Florida Medicaid Florida Medicaid covers a variety of medical services. 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. 0000063950 00000 n 0000019903 00000 n Health Plan Portal User Manual. Email Advisory | 0000025810 00000 n 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. Provider. Please note that a new browser window will open. Business Name Enter Business Name for Establishments or Last Name for Practitioner Last Name First Name City County Zip Code License Status | r]G(c>|2]eVg\PP 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). Left navigation requires javascript to be enabled in your browser. 805 0 obj <>/Filter/FlateDecode/ID[<08E51282E405684D9C17F1CE6F8C1661><5571271B0099974DBF27615CD82AD9C9>]/Index[786 41]/Info 785 0 R/Length 100/Prev 808182/Root 787 0 R/Size 827/Type/XRef/W[1 3 1]>>stream Out-of-State Registered providers enrolled as provider type 16 RESIDENTIAL AND FREESTANDING PSYCHIATRIC FACILITY. 49 0 obj <> endobj xref Address Maintenance Wizard: The current Change of Address (COA) Wizard has been renamed to the Address Maintenance Wizard. A new application must be submitted if the ATN was terminated before March 2022. 1) and then clicking on Florida Medicaid Taxonomy Guide (you may be prompted to download the spreadsheet if it doesn't open automatically). To access the tool, login to the secure Web Portal by clicking the Secure Web Portal Login button above. Beginning March 1, 2022, an enhancement will be applied to the NPI Mapping Logic which will affect providers and health plans who submit claims and/or encounters to Florida Medicaid. Box 5197, MS 62 Tallahassee, FL 32314; Report Medicaid Fraud . `]).vpF'~E/\YY6GK%p &JjcsJ>z$W Kd2~@:_oVwL%JK1 v?x7#2B_>:f/7*jg*I3qnuDQgktd.S=~L\"#K7[G^3P0F>gf)8?&{y>h**|@lhb%85Px>jEff;HhCA?1gRhah8;?xuAk?yg?!yN?f~@oF 10/31/22. Sunshine Health is a managed care plan with a Florida Medicaid contract. Toll Free: (877) 423-4746. State Profiles Every state's Medicaid and CHIP program is changing and improving - most states are expanding coverage for low-income adults; all states are modernizing their Medicaid/CHIP eligibility, enrollment and renewal processes and systems, and taking advantage of many of the new flexibilities provided by the Affordable Care Act. Primary: (404) 657-5468. And to get an NPI, your application will need to include the taxonomy code that reflects your classification and specialization. hbbd```b``65 d3E`rX$LX$XDNL q%VV@&F`Jg-@ T An updated Provider Master List tip sheet is now available on the Managed Care Support section of the Complete one or more search fields. Use the, Verify your information matches what you submit on your claims. 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 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. 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- ? YM}O}H-~u.:t `'m@#q# t3>:khAC^Qdb.KktxU#\^Xuv=5 Detail Default Pay Multiple Service Locations, Ordering Please be sure to submit all five pages of the attestation. 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. 0000019074 00000 n The agency will be posting related updates to X12 837 companion guides soon. Effective February 25, 2022, the following self-service features will be available: NPI Self-Service: The new NPI self-service feature will allow providers to update or add a new NPI to the Medicaid provider ID associated to the account the provider is logged into. 786 0 obj <> endobj You also have to meet Nursing Facility level of care. 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. 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). X Providers HCBS Incident Reporting System Medicaid Pharmacy Preferred Drug Lists Provider Forms Provider Types Public Notices . _b>? For Providers Addiction Recovery and Treatment Services, Behavioral Health, Dental, Foster Care, High Needs Support, Long Term Care, Managed Care, Maternal and Child Health, Pharmacy Services and more DMAS - Department of Medical Assistance Services Cardinal CareVirginia's Medicaid Program Department of Medical Assistance Services Menu Sitemap The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. + 7B endobj An official website of the United States government Or start a search using ourFind A Providertool. Locate the appropriate taxonomy code that is . PLEASE CHECK SPELLING, SPACING, ATTENDING SERVICE ADDRESS IS INVALID- Any provider that has a payment suspension based on a credible allegation of fraud within the last 10 years,[23] Any provider excluded within the past 10 years by HHS-OIG or an SMA,[24, 25] Any provider that has a qualifying Medicaid overpayment,[ 26] The provider is enrolling within 6 months of the date of the lifting of a The Florida Medicaid Web Portal supports the Microsoft Edge Chromium browser which can be downloaded from the Microsoft website. 0000048537 00000 n Florida Department of Health | Division of Medical Quality Assurance Search Services, To verify a Nurse Licensure Compact Multi-State RN or LPN License, access. Please contact the Public Records office for questions about the public records requests. Transactions submitted with a From Date of Service of February 28, 2022, or earlier should use the taxonomy associated with the NPI Crosswalk. Action Required: Please complete the application wizard with AHCA online to renew and/or complete your Medicaid ID registration. 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. Default Pay Multiple Service Locations, Referring In Florida, most Medicaid recipients are enrolled in the Statewide Medicaid Managed Care program. 0000025923 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. 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. stream 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. 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. YouTube page for Georgia Medicaid; How can we help? Please visit the Hurricane Preparedness page frequently to remain up-to-date with the latest information as it is made available. 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 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. This requirement also helps ensure we have the proper information needed to promptly pay your claims. NPI to Medicaid ID Search Engine: The existing tool has been enhanced and is accessible via the secure Web Portal. 0000048907 00000 n Some providers may not perform certain services based on religious or moral beliefs. No records found. Call Us. Medicaid Provider Directory - Region 3 (PDF) Serving Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union counties Medicaid Provider Directory - Region 4 (PDF) Serving Baker, Clay, Duval, Flagler, Nassau, St. Johns and Volusia counties Health plans can access the sample test files with the new layout on the Submission Information page of the Florida Medicaid Web Portal. The Florida Medicaid Taxonomy Guide, found under Enrollment Forms on the Florida Medicaid Web Portal, open_in_new identifies taxonomies that correlate to provider types and specialties FLMMIS Provider Enrollment open_in_new lists provider types Claims, Billing and Payments on UnitedHealthcare Provider Portal to review and resubmit claims Questions? The Agency will implement the revised PML and PPL formats on February 25th, 2022. 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 To verify a Nurse Licensure Compact Multi-State RN or LPN License, access NURSYS License Number Enter License Prefix and License Number with no spaces, leading zeros or colons. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Master List of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Items Potentially Subject to Conditions of Payment, Medicare Fee-for-Service Compliance Programs, Master List of DMEPOS Items Potentially Subject to Conditions of Payment, Supplemental Medical Review Contractor (SMRC), Required Face-to-Face Encounter and Written Order Prior to Delivery List (PDF). 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. <> 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.

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