Contact the Provider Services Call Center (PSCC) at 1-800-289-7799, Option 5. Florida residents may use the ACCESS Florida site so as to check on the status of submitted applications. However, fee-for-service exceptional and out-of-state paper claims will continue to be accepted. © 2020 Florida Agency for Health Care Administration, https://myflfamilies.com/covid19/access.shtml, Your Protections under the Americans with Disabilities Act, Helpful Brochures, Pamphlets, and Other Agency Approved Publications, Detailed Information About the SMMC Program. An option adviser is available to help in the choice of a managed care plan by calling 1-877-711-3662. Medicaid eligibility in Florida is determined either by the Department of Children and Families (DCF) or the Social Security Administration (for SSI recipients). Providers may contact the Provider Enrollment Contact Center with any inquiries at 1-800-289-7799, Option 4.
Florida Medicaid recipients are expected to enroll in a managed care plan once approved for coverage. The Agency for Health Care Administration and Department of Children and Families have been working together to ensure current Medicaid recipients maintain benefits during the 2019 novel coronavirus (COVID-19) state of emergency. Welcome to Florida Department of Children and Families Automated Community Connection to Economic Self Sufficiency (ACCESS). The ACCESS Florida system allows customers to connect with their public assistance information 24/7, through the …
Florida’s population is estimated to be 20,271,272 and of these residents, 3.3 million have been covered under the Medicaid program. This tool can be found on the Quick Reference Guides page, under the Provider Services tab. Eligibility for coverage under the program is tied into the national poverty level. DCF determines Medicaid eligibility for: Parents and caretakers relatives of children. 2727 Mahan Drive
Florida Medicaid providers will have two options to submit Medicaid claims for processing. (adsbygoogle = window.adsbygoogle || []).push({}); This website is not a government website or government affiliated website. Medicaid is the medical assistance program that provides access to health care for low-income families and individuals. The list of certified browsers can be found on the, Paid Claims Listing for Institutional and Non-Institutional (Fee for Service, Managed Care, Paid and Denied), Long Term Care Paid Claims Listing (Fee for Service and Managed Care), Medicare/Medicaid Crossover (Paid or Denied Claims). will be closed Thursday, November 26, 2020 and Friday, November 27, 2020, in observance of the
Closure document for a comprehensive list of 2020 scheduled holidays.
This website does not, for a fee, reproduce, reprint or distribute any item consisting of a form, application or other publication of the Social Security Administration or the Department of Health and Human Services.
This organizational chart will help you navigate our site. Please review the Known Issues and Informational Items List for details listed related to the MMIS. For questions or information about prior authorizations, the following resources are available on the eQHealth Website at http://fl.eqhs.org, under the Behavior Analysis Tab.
Additional information can be found at the official government website ssa.gov.
To that end, we are taking the following actions. The Agency for Health Care Administration has published a revised Provider Background Screening page on the Medicaid public Web portal. Effective March 18, 2019, the encounter.attestation@dxc.com email address designated for all attestation submissions will be discontinued. Permanent Medicaid gold cards are issued for each recipient who is eligible for Medicaid. (adsbygoogle = window.adsbygoogle || []).push({}); HCPCS Codes reviewable by eQHealth Solutions.
Archived alerts are posted in the public Web Portal on the Provider Alerts page and the Managed Care Alerts page. In Florida, the Agency for Health Care Administration (Agency) is responsible for Medicaid.
Once PSCC has reset your password, log in to the Secure Web Portal.
Prepayment Reviews and Payment Restrictions:
For more information, please contact AHCA’s Office of Medicaid Program Integrity at 850-412-4600. To configure a security question, follow these steps: Important Reminder: Passwords expire every 60 days.
Thanksgiving holiday.
Additional information can be found in the Special Feed Elimination FAQ, located in the FAQ section of the Managed Care Support page. Individuals and households residents must make a significantly low income so as to be eligible for Medicaid coverage.
To ensure all providers and insurers have access to the most up-to-date information on this initiative, a new NMCP page has been created under the Agency Initiatives tab of the public Web Portal. Florida Medicaid is the state and Federal partnership that provides health coverage for selected categories of people in Florida with low incomes.
Nothing in this website should be considered legal, financial or accounting advice. AHCA notifies the providers who are placed under prepayment review or withholding of payments via written correspondence mailed to the address on file. Medicaid, Provider Fee Schedules and Provider Handbooks, Quality Management and Research and Evaluation Contracts, Bureau of Medicaid Recipient and Provider Assistance. The Florida Medicaid program offers coverage to the following groups of individuals: Those who receive Supplemental Security Income are automatically qualified to receive Medicaid benefits in the state of Florida. The Agency for Health Care Administration (Agency) will be implementing the New Medicare Card Project (NMCP) in order to meet requirements detailed in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which mandates the Centers for Medicare & Medicaid Services (CMS) remove all SSNs on all Medicare beneficiary cards. Providers are encouraged to submit all required supporting documents at the same time for the pending application. Beth Kidder
Despite the fact that the nation has yet to expand Medicaid, its enrollment has increased because of the outreach efforts of Affordable Care Act navigators. For all questions regarding prepayment review, providers are encouraged to review the guidance provided within the written correspondence distributed by AHCA. Providers are encouraged to visit the revised Background Screening page to review new information related to the types of screening activities that are performed by the Agency, as well as general information related to the requirement for providers to disclose ownership and controlling interest information and to submit to fingerprinting. Approved Medicaid applicants will be given a golden Medicaid card in the mail. The claims processing changes are informational only and will not result in a denial at this time.
For general inquiries, inquiries that cannot be addressed through eQSuite, or if you have a complaint, contact the eQHealth toll free customer service number 855-444-3747. Replacement cards can be requested by phoning 1-866-762-2237. It is imperative that you do not attempt to use a bookmarked Web address that begins with "https://sso.flmmis.com." Before submitting the application, providers must ensure that the application type, enrollment type, and provider type selected are accurate. Providers will no longer be required to upload the forms with enrollment applications, as this information is now being captured when completing an application using the online enrollment wizard. Address updates can be completed using the Change of Address Wizard.
The Agency for Health Care Administration (Agency) is commencing two provider screening initiatives to require all providers who refer, order, prescribe, or attend in conjunction with the provision of services to Florida Medicaid recipients and all providers who participate in the network of a Medicaid managed care plan to enroll in the Florida Medicaid program. About ACCESS. Reflects Medicaid state plan coverage of the eligibility group for parents and other caretaker relatives. On the home page, click “Account Management”.
Paper claims received on or after this date, from in-state providers, will not be processed.
Mail Stop #8
The discharge date will now be used in place of admission date for the retrieval of all applicable DRG pricing parameters including the following: Prior to this system change, the discharge date used to retrieve the ICD mapping date and grouper version, while the parameters above used admission date. For more information, providers should contact AHCA’s Bureau of Medicaid Fiscal Agent Operations at 850-412-3462.
Group membership details can be updated in real-time using the Members of My Group and Group Membership panels. Users should consult a professional for their own decisions. On Saturday January 25, 2020, the FMMIS homepage (https://home.flmmis.com/home/) login screen will be changing. People who have been denied for Medicaid coverage may appeal the decision. Once signed up for the Provider Alerts, the provider will receive any alert AHCA posts that pertains to that provider's type or region.
People who have been denied for Medicaid coverage may appeal the decision.
Health plans are encouraged to monitor future alerts for additional information regarding the new enhancements. These items cannot be altered once an Application Tracking Number (ATN) has been assigned.