florida medicaid provider master list

Please note that a new browser window will open. Please visit the Hurricane Preparedness page on the public Web Portal under the Agency Initiatives tab. See the Florida Medicaid Provider Registration Guidefor directions for successfully completing the form. 0000014536 00000 n 2023 Accurate Biometrics, Inc. | All rights reserved. website belongs to an official government organization in the United States. 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 This impacted providers who had more than one state Medicaid ID. `]).vpF'~E/\YY6GK%p &JjcsJ>z$W Kd2~@:_oVwL%JK1 v?x7#2B_>:f/7*jg*I3qnuDQgktd.S=~L\"#K7[G^3P0F>gf)8?&{y>h**|@lhb%85Px>jEff;HhCA?1gRhah8;?xuAk?yg?!yN?f~@oF PML - Provider Master List. The Agency for Health Care Administration (Agency) and its fiscal agent, Gainwell Technologies, would like to notify providers of upcoming enhancements to the Florida Medicaid secure Web Portal. Primary: (404) 657-5468. For more information, or to submit questions related to the new layout, please email the Health Plan Support team at: healthplan.support@gainwelltechnologies.com. The Agency for Health Care Administration (Agency) and the Agency's fiscal agent, Gainwell Technologies (Gainwell), have enacted the NPI Crosswalk Elimination initiative to mitigate NPI Crosswalk data issues. INVALID, REFERRING SERVICE ADDRESS IS INVALID- AHCA requires that every provider who participates with Medicaid or CHIP beneficiaries maintain an active status on their Medicaid ID. Default Pay Multiple Service Locations, Attending The QRG Page has links to the NPI Self-Service Tool QRG, Address Maintenance Wizard QRG and other useful resources. Toll Free: (877) 423-4746. 0000001251 00000 n 0000074223 00000 n 0000013101 00000 n In support of validation that a health care provider meets these requirements, AHCCCS publishes two listings as follows on a regular basis: AHCCCS Active, Registered Providers by NPI who may Refer, Order, Prescribe, or Attend ROPA Excepted Providers List (Residents, Interns, Pharmacists) Steps To Comply with ROPA During the Registration Extension *@ ?&ny`mk(>sUM'A{808+D5RtJ)NK'KL.pn& E|mH.kvzYE.=,-2u-Gpf! hbbd```b``A$"Y &$3&8d SIt+ 0000000016 00000 n Providers and health plans are encouraged to review the tip sheet to understand how the enhancement will affect their claims and/or encounter submissions. Providers who fail to sign the agreement will be subject to audits and recoupment of funds associated with the minimum wage requirement. endstream endobj 787 0 obj <>/Metadata 53 0 R/Pages 784 0 R/StructTreeRoot 74 0 R/Type/Catalog>> endobj 788 0 obj <>/MediaBox[0 0 612 792]/Parent 784 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 789 0 obj <>stream Provider. 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 Questions? 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, Statewide Medicaid Managed Care Registered Provider Initiative form (PDF), medicaideligibilityoutreach@ahca.myflorida.com, Call 1-800-289-7799, Option 4 for any additional provider enrollment questions. Complete Enrollment for Your Medicaid ID. All rights reserved. TAXONOMY IS NOT VALID FOR REFERRING PROVIDER, TAXONOMY IS INVALID - DTL REFERRING PROVIDER, TAXONOMY IS MISSING - DTL REFERRING PROVIDER, TAXONOMY IS NOT VALID FOR DTL REFERRING PROVIDER, ROPA Taxonomy Is Invalid Attending Provider, ROPA Taxonomy Is Not Valid For Attending Provider, ROPA Taxonomy Is Missing Attending Provider, ROPA Taxonomy Is Not Valid For Ordering Provider, ROPA Taxonomy Is Invalid Dtl Ordering Find a Provider For Members For Providers Get Insured Coronavirus Information For Providers Value-Based Incentive Programs Billing and Claims Utilization Management Coronavirus Information Become a Provider Contact Us Eligibility Verification Login Pharmacy Pre-Auth Check Provider News Provider Resources Provider Complaints Assessment Tools 0000073968 00000 n ) Agency for Health Care Administration; P.O. Sunshine Health is a managed care plan with a Florida Medicaid contract. For instructions, see ourFind A Provider Step-by-Step Guide (PDF). 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. The following self-service features are now available: NPI Self-Service Feature: A new NPI self-service tool is available to all providers via the secure Web Portal. 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." To access the tool, login to the secure Web Portal by clicking the Secure Web Portal Login button above. endobj Address Maintenance Wizard: The current Change of Address (COA) Wizard has been renamed to the Address Maintenance Wizard. 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. You also have to meet Nursing Facility level of care. 0000042555 00000 n The Agency is aware of concerns regarding requiring all organizational (Type 2) providers to acquire and apply new NPIs to their current and future service locations. %PDF-1.4 % 2 Prov 2 Default Pay Multiple Service Locations, To view the complete list of CORE/CAQH Compliant EOB Clarifications, visit our website at: 835 | Florida Medicaid Web Portal (flmmis.com), For more information, or to submit questions related to the revised edits, email the Health Plan Support team at healthplan.support@gainwelltechnologies.com. Please review the Known Issues and Informational Items List for details listed related to the MMIS. hbbd```b``65 d3E`rX$LX$XDNL q%VV@&F`Jg-@ T The Master List serves as a library of Fee-for-Service DMEPOS codes that were flagged as potential vulnerabilities based on the criteria outlined in CMS-1713-F. As of April 13, 2022, the Master List includes 439 items. (Updated 02/15/2023). 0000017512 00000 n 0000011307 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. 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 PLEASE CHECK SPELLING, SPACING, ATTENDING SERVICE ADDRESS IS INVALID- endobj They are located on the AHCA public web portal under Provider Services/EDI/Companion guides. Statewide Medicaid Managed Care (SMMC) is the program where most Medicaid recipients receive their Medicaid services. 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. If you would like to search for a complete list of licensed providers, please visit our data portal. 0000063950 00000 n 7:30 AM - 6 PM ET. Provider, ROPA Taxonomy Is Missing Dtl Ordering PLEASE CHECK SPELLING, SPACING, REFERRING 2 SERVICE ADDRESS IS INVALID- You may also search for CMS providers in your area by selecting the regional provider directory for your county from the table below. Action Required: Please complete the application wizard with AHCA online to renew and/or complete your Medicaid ID registration. Sign up to get the latest information about your choice of CMS topics. 3 0 obj Need access to the UnitedHealthcare Provider Portal? 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. Largest Cities in Florida Miami 52,853 Tampa 26,198 Orlando 24,833 Jacksonville 24,345 Gainesville 13,594 Hialeah 10,407 Fort Myers 8,132 West Palm Beach 7,683 Sarasota 7,607 Boca Raton 7,591 Online Form. INVALID- PLEASE CHECK SPELLING, SPACING, ORDERING SERVICE ADDRESS IS INVALID- Please review the Holiday Office 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. T(z2Vxv2m.4.7\m^n\mo!zN??^rK5J~(^zL 0000020302 00000 n Please review the Scheduled Maintenance %PDF-1.5 % To distribute the funds appropriated for the Medicaid provider minimum wage requirement, AHCA has been directed to increase Medicaid managed care reimbursement rates and certain Medicaid fee-for-service fee schedules. PLEASE CHECK SPELLING, SPACING, REFERRING DETAIL SERVICE ADDRESS IS INVALID, REFERRING 2 ZIP CODE IS MISSING/ Send a Message. PLEASE CHECK SPELLING, SPACING. 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. endobj code to match the state Provider Master List (PML). 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 0000024293 00000 n 0000025923 00000 n 0000022399 00000 n 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. Find a Provider Contact Us. 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 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. 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. Please visit the Hurricane Preparedness page frequently to remain up-to-date with the latest information as it is made available. E I IW42@ Va~(i&^ L ,d(SJ{K"K7(52jT^FT,48P$1XT4k8e. <>/Metadata 210 0 R/ViewerPreferences 211 0 R>> Additional information can be found on the ROPA page, under the Agency Initiatives tab on the public Web Portal. 2 0 obj Email Us. Community Care Plan (CCP) is a Provider Service Network (PSN) in Broward County. TIN - Tax ID Number . Accessibility, document.write(new Date().getFullYear()) FL HealthSource, All Rights Reserved 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. 0000026034 00000 n 0000041273 00000 n endstream endobj startxref lock <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 29 0 R 30 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 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. 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 DXC will add the provider to the Florida Medicaid Management Information System (FLMMIS) and the Provider Master List, so that after the provider is paid encounters will successfully process in the FLMMIS. 0000001036 00000 n To become a Medicare provider and file Medicare claims, you must first enroll in the Medicare program. You can decide how often to receive updates. Florida Medicaid. If you dont take action by your PML expiration date, you will be terminated from the Sunshine Health network on your PML expiration date. providers that render services to eligible Medicaid recipients. The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county & community efforts. Box 5197, MS 62 Tallahassee, FL 32314; Report Medicaid Fraud . 0000025810 00000 n As part of the Registered Provider Enrollment Initiative, the Agency for Health Care Administration (AHCA) is offering enrollment assistance to Skilled Nursing Facilities, Assisted Living Facilities (ALFs) and Residential and Freestanding Psychiatric Facilities that are actively seeking compliance with the Registered Provider Initiative. or 0000019074 00000 n A new application must be submitted if the ATN was terminated before March 2022. Transactions submitted with a From Date of Service of March 1, 2022, or later must use a valid taxonomy associated with the providers specialty. Date: 10/31/22. Please try your search again with other search values. The Agency is also required to enter into a supplemental wage agreement with each impacted Medicaid Provider by October 1, 2022, to ensure compliance with the minimum wage requirements. No records found. Please be sure to submit all five pages of the attestation. 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. 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. 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. r>LFoc6rw,0-ccIp3@IqusJ. 2 Default Pay Multiple Service Locations, Facility 0000026103 00000 n Sign in with your Florida Medicaid account (use new password if you recently completed a reset). Default Pay Multiple Service Locations, Referring 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. 4 0 obj X Providers HCBS Incident Reporting System Medicaid Pharmacy Preferred Drug Lists Provider Forms Provider Types Public Notices . COMMERCIAL, SELF-INSURED EMPLOYEE HEALTH PLANS. Business Name Enter Business Name for Establishments or Last Name for Practitioner Last Name First Name City County Zip Code License Status

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