Agent Portals

ahca medicaid fiscal agent web portal

by Mr. Myles Hagenes Sr. Published 5 months ago Updated 4 months ago
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What is the Florida Medicaid web portal?

Florida Medicaid's Web Portal solution provides communication and self-service tools to the provider community.

Where can I find more information on AHCA?

For more information on AHCA, please visit Consumer Information. For questions or information, you may contact the Agency for Health Care Administration by feedback form or by phone toll-free at (888) 419-3456.

How do I contact the Florida Agency for health care administration?

For questions or information, you may contact the Agency for Health Care Administration by feedback form or by phone toll-free at (888) 419-3456. The Florida Agency for Health Care Administration created FloridaHealthFinder.gov to provide easy access to health care information.

What is Medicaid provider enrollment?

Provider Enrollment is responsible for enrolling qualified providers to receive Medicaid reimbursement for services rendered to Medicaid Fee-For-Service recipients. Florida Medicaid's Web Portal solution provides communication and self-service tools to the provider community.

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What is the website for Florida Medicaid?

www.myflorida.com/accessfloridaIndividuals may apply for assistance online at: www.myflorida.com/accessflorida/ Additional information about Medicaid for low income families is available in the Family-Related Medicaid Fact Sheet.

How do I get a Medicaid provider number in Florida?

How to Apply for a Medicaid Provider Number in the State of...Obtain a Florida Medicaid Provider Application. ... Complete the Florida Medicaid Provider Application. ... Submit the completed Medicaid Provider enrollment form to the Florida agency that corresponds with your practice.

How do I check my Medicaid status in Florida?

Providers can check eligibility for the displaced Florida Medicaid recipients that are being serviced by calling the Florida Medicaid Automated Voice Response System (AVRS) at the following phone number: 1-800-239-7560. number to verify recipient eligibility.

What is Flmmis?

Florida Medicaid Management Information System (FMMIS means the computer system used to process Florida Medicaid claims and to produce management information relating to the Florida Medicaid program.

How do I contact my local Medicaid office?

Centers for Medicare and Medicaid ServicesWebsite: Centers for Medicare and Medicaid Services (CMS)Contact: Contact the Centers for Medicare and Medicaid Services (CMS)Local Offices: Contact State Medicaid Offices.Toll Free: 1-800-633-4227. ... TTY: 1-877-486-2048.Forms: Centers for Medicare and Medicaid Services Forms.

How do I renew my Medicaid provider number in Florida?

For assistance with the AHCA Medicaid ID and renewal process or updating your information, call 1800-289-7799, Option 4. For assistance with accessing the Medicaid Secure Portal, call 1-800-289-7799, Option 7.

How do you check if my medical is active?

You can also check on your Medi-Cal status by calling the Medi-Cal hotline at (800) 541-5555. If you're outside of California, call (916) 636-1980.

Does Florida Medicaid automatically renew?

During the 10th month of the eligibility period, the system will automatically start the renewal process by attempting to perform an electronic data match.

How do I know if I have Medicaid?

Call your State Medical Assistance (Medicaid) office for more information and to see if you qualify. You can also call 1-800-MEDICARE (1-800-633-4227) to get the phone number for your state's Medicaid office. TTY users can call 1-877-486-2048.

Who is my Florida Medicaid provider?

"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."

Can you balance bill a Florida Medicaid patient?

Balance billing does not apply when collecting deductibles, copayments or coinsurance. Under Florida law, a provider may not balance bill a patient for any service, if an HMO is liable and responsible for payment. Contrary to what many people believe, this is true whether you are in-network or out-of-network.

How do I change my Medicaid provider in Florida?

If you want to switch from your current Medicaid plan and enroll in Humana Healthy Horizons™ in Florida, you can:Text ENROLL to FLSMMC (357662) ... Go to FLMedicaidManagedCare.com. ... Call the Helpline to speak with a Choice Counselor at 1-877-711-3662.

How do I apply for Florida Medicaid?

Medicaid provides free or low-cost health coverage to eligible needy persons....You must also be one of the following:Pregnant, or.Be responsible for a child 18 years of age or younger, or.Blind, or.Have a disability or a family member in your household with a disability, or.Be 65 years of age or older.

How do I change my Medicaid provider in Florida?

If you want to switch from your current Medicaid plan and enroll in Humana Healthy Horizons™ in Florida, you can:Text ENROLL to FLSMMC (357662) ... Go to FLMedicaidManagedCare.com. ... Call the Helpline to speak with a Choice Counselor at 1-877-711-3662.

Does Medicaid cover ABA therapy in Florida?

Behavior Analysis services are provided to all eligible Florida Medicaid recipients under the age of 21 years requiring medically necessary BA services.

How do I activate my newborn Medicaid in Florida?

Providers and Medicaid managed care plans should submit a newborn activation request through the Newborn Activation feature in the Florida Medicaid Secure Web Portal and Florida Health Plan Portal. Additional instructions and a quick reference guide can be found on the Florida Medicaid Web Portal.

What is the phone number for medicaid in Florida?

Phone: (850) 412-4000. Medicaid is the medical assistance program that provides access to health care for low-income families and individuals. Medicaid also assists the elderly and people with disabilities with the costs of nursing facility care and other medical and long-term care expenses. In Florida, the Agency for Health Care Administration ...

Can you lose Medicaid in Florida?

This means no Medicaid recipient will lose Medicaid eligibility during the public health emergency*. *Exceptions include individuals who voluntarily request termination, those who have passed away, or those who are no longer considered residents of Florida.

What is the fax number for Medicaid in Florida?

Fax: (850) 410-1430. The Bureau of Fiscal Agent Operations has oversight responsibilities for the Fiscal Agent provider enrollment, claims processing and payment, management of the the Florida Medicaid Management Information System (FMMIS) and the Decision Support System (DSS).

What is the bureau section of Medicaid?

The bureau section provides coordination of Fiscal Agent provider enrollment functions, provider data maintenance, outreach, education, and issue resolution to providers, the Medicaid managed care plans, the Medicaid Regional Offices, and program operating partners at the Department of Health and the Agency for Persons with Disabilities.

Plan and Provider Enrollment and Outreach

Responsible for assisting plans and providers with the provider enrollment process, both initial and renewal; submitting provider maintenance to the Medicaid fiscal agent; receiving, tracking, and monitoring escalated issues, legislative requests, and public records requests; performing onsite reviews; coordinating and delivering plan and provider trainings related to provider enrollment; providing support for new plan enrollments under SMMC procurement, and coordinating with external agencies, including APO and DOH, regarding provider enrollment..

Provider Eligibility and Compliance

Responsible for ensuring the continued eligibility of enrolled providers through research and validation of providers who are excluded from participation in Medicare, Medicaid, or other federally-funded programs; documenting justifications for exclusions from Florida Medicaid; coordinating with Medicaid Program Integrity and the OGC regarding referrals for legal sanctions; monitor provider background screening processes taking appropriate actions when providers have disqualifying offenses; participate on the Clearinghouse Advisory Board; coordinate with Medicare related to mismatches in provider data between PECOS and the MMIS; coordinate requests for onsite reviews with the RPA Onsite Review Desk; perform change of ownership reviews, including determining if there is any pending enforcement action by MPI or MFCU, verify accuracy of ownership disclosures, and identify any money owed by the seller or the buyer; and participate in an interagency workgroup on provider license compliance..

Provider Business Module Management

Responsible for the business of provider enrollment.

When does Medicaid exceptional claim end?

COVID-19 Request for Exceptional Claims Processing for dates of service effective March 9, 2020 and ending June 30, 2021 for behavioral health services and ending July 14, 2021 for Medicaid prior authorization requirements for behavioral health services.

What is a CMS plan?

Children’s Medical Services Health Plan (CMS Health Plan) is a Statewide Medicaid Managed Care (SMMC) Managed Medical Assistance (MMA) Specialty Plan for children and youth with special health care needs. This plan is offered by the Florida Department of Health who has contracted with WellCare of Florida, Inc to provide managed care services to our members. You can visit www.CMSPlanFlorida.gov to learn more.

When will Medicaid be reinstated?

Effective for dates of service beginning July 1, 2021, service limits will be reinstated for behavioral health services. Effective Jul y 15 , 2021, Medicaid prior authorization requirements will be reinstated for behavioral health services.

How to contact AHCA?

For questions or information, you may contact the Agency for Health Care Administration by feedback form or by phone toll-free at (888) 419-3456.

What is Medicaid in Florida?

Medicaid is the medical assistance program that provides access to health care for low-income families and individuals. Medicaid also assists the elderly and people with disabilities with the costs of nursing facility care and other medical and long-term care expenses. In Florida, the Agency for Health Care Administration (Agency) ...

What is SMMC in Florida?

In 2011, the Florida Legislature created Part IV of Chapter 409, Florida Statutes, directing the Agency to create the Statewide Medicaid Managed Care (SMMC) program. The SMMC program has two key components: the Managed Medical Assistance program and the Long-term Care program.

What is the health care bureau?

Handles health care licensure, Medicare and Medicaid certification, and regulation for hospitals, ambulatory surgical centers, home health agencies, hospices, clinical laboratories, nursing homes, assisted living facilities and all other types of health care providers. The Bureau also includes the health care risk manager licensure program, the organ donor education/registry program, and commercial managed care programs, and is the location of the certificate of need (CON) program, which reviews applications for new facilities and certain specialized services at hospitals, nursing homes, hospices and intermediate care facilities for the developmentally disabled.

What is the Medicaid program coordination?

The Program Coordination Section is responsible for the development and implementation of infrastructure to support project/initiative tracking and accountability, and project management and process improvement efforts for the Division of Medicaid. The Program Coordination Section is also responsible for the coordination and support of Division of Medicaid activities including correspondence, public records, Medicaid provider alerts and the Quarterly Medicaid provider bulletins, maintenance of the Florida Medicaid provider Training e-Library, coordination of the Medical Care Advisory Committee and other cross divisional activities.

What is the Office of Plans and Construction?

The Office of Plans and Construction is primarily responsible for ensuring that hospitals, nursing homes, ambulatory surgical centers, and Intermediate Care Facilities for the Developmentally Disabled (ICF/DD) are safe, functional, and provide safety-to-life for the patients and residents.

How to contact the agency for health care administration?

Contact Us. For questions or information, you may contact the Agency for Health Care Administration by feedback form or by phone toll-free at (888) 419-3456.

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Plan and Provider Enrollment and Outreach

  • Responsible for assisting plans and providers with the provider enrollment process, both initial and renewal; submitting provider maintenance to the Medicaid fiscal agent; receiving, tracking, and monitoring escalated issues, legislative requests, and public records requests; performing onsite reviews; coordinating and delivering plan and provider trainings related to provider enroll…
See more on ahca.myflorida.com

Provider Eligibility and Compliance

  • Responsible for ensuring the continued eligibility of enrolled providers through research and validation of providers who are excluded from participation in Medicare, Medicaid, or other federally-funded programs; documenting justifications for exclusions from Florida Medicaid; coordinating with Medicaid Program Integrity and the OGC regarding referrals for legal sanction…
See more on ahca.myflorida.com

Provider Business Module Management

  • Responsible for the business of provider enrollment. Staff will design, develop, and implement solutions for provider regulation compliance through close coordination with the Centers for Medicare and Medicaid Services, the Office of the Inspector General, and Medicaid Program Integrity, and other states' Medicaid programs; coordinate with internal and external partners in …
See more on ahca.myflorida.com

Resource Information

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