Provider Support provides research and technical support for Medicaid Fee-For-Service claims inquiries and processing issue resolution. Provider Enrollment. Florida Medicaid contracts with a Fiscal Agent for provider enrollment, management of the beneficiary file/records Medicaid Fee-For-Service claims processing and payment. We would like to show you a description here but the site won’t allow us. These teams provide coordination of 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. Responsible for the business of provider enrollment. (See OAC 5160-1-17.8 – formerly OAC 5101:3-1-17.8 for additional information about provider screening requirements). WellCare of Florida, Inc., doing business as Staywell (WellCare) understands that having access to the right tools can help you and your staff streamline day-to-day administrative tasks. 1.3.6 Provider The term used to describe any entity, facility, person, or group that has been approved for enrollment or registered with Florida Medicaid. 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 If you are the treating physician of a child and you would like to attest to the eligibility of your patient for the CMS plan, please review the If physicians have questions about the CMS Clinical Eligibility Attestation, please contact a CMS plan nurse at 1-855-901-5390. For assistance contact 1-877-254-1055.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. Responsible for the business of provider enrollment. Sign in with your Florida Medicaid account (use new password if you recently completed a reset). For assistance contact 1-877-254-1055.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. Florida Medicaid contracts with the following entity to perform Prior Authorization/Utilization Management services. Additional questions from providers may be directed to the Florida Medicaid Helpline at 1-877-254-1055. 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. Becoming a Provider is a Free Process *All APD Provider Enrollment documents may be found in the document portion of the website HERE. Medicaid Choice Counselors are available to help you enroll in a plan that best fits your needs.   Provider Enrollment Provider Enrollment is responsible for enrolling qualified providers to receive Medicaid reimbursement for services rendered to Medicaid recipients. Provider Enrollment Help Line Information Florida Medicaid's Web Portal solution provides communication and self-service tools to the provider community. Speak with a choice counselor via phone at 1-877-711-3662 Monday – Thursday 8:00am – 8:00pm and Friday 8:00am – 7:00pm. These teams provide coordination of 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. iStock . The Agency will complete the credential v\rification process and site … Beth Kidder Deputy Secretary for Medicaid 2727 Mahan Drive Mail Stop #8 Tallahassee, FL 32308 Phone: (850) 412-4000 Federal and state laws require some providers to have pre- and post-enrollment on-site screening visits to ensure program integrity. 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. To learn more about the provider enrollment process for behavior analysis services, please review the presentation materials on the Agency’s website. Florida Medicaid contracts with a Fiscal Agent for provider enrollment, management of the beneficiary file/records Medicaid Fee-For-Service claims processing and payment. Reversing a three-year decline, the number of people covered by Medicaid nationwide rose markedly this spring as the impact of the recession caused by … There are five steps to the enrollment process.\爀屲First, an Enrollment application is submitted on the Florida Medicaid Web Po\൲tal via the Online Enrollment Wizard.\爀屲Next, the Enrollment Application is evaluated based on the enrollment rules. Provider Enrollment is comprised of three business teams, Plan and Provider Enrollment and Outreach, Provider Eligibility and Compliance, and Provider Business Module Management.