Florida medicaid billing manual

FLORIDA MEDICAID PROVIDER GENERAL HANDBOOK How to Use the Update Log Introduction The current Medicaid provider handbooks are posted on the Medicaid fiscal agent’s Web site at www.doorway.ru Select Public Information for Providers, then Provider Supp ort, and then Provider Handboo ks. Changes. This Manual replaces and supersedes any previous versions dated prior to J, and is. available on WellCare’s website at. www.doorway.ru A paper copy may be obtained, at no charge, upon request by contacting Provider Services or a . In , the Florida legislature established the Florida Medicaid program as a statewide, integrated managed care program for all covered services, including long-term care. This program is referred to as the Statewide Medicaid Managed Care (SMMC) program, which is administered by the Florida Agency for Health Care Administration (AHCA).

expenses. In , the Florida Medicaid program implemented a new system through which Medicaid enrollees receive services. It is referred to as the Statewide Medicaid Managed Care (SMMC) program. Most Medicaid recipients must enroll in a health plan that was selected through a competitive procurement to participate in the SMMC program. The provider must adhere to all billing requirements in order to ensure timely processing of claims and to avoid unnecessary rejections and/or denials. Claims will be rejected or denied if not submitted correctly. In general, Sunshine He alth follows CMS (Centers for Medicare Medicaid Services) billing requirements. The purpose of the Medicaid handbooks is to provide the Medicaid provider with the policies and procedures needed to receive reimbursement for covered services provided to eligible Florida Medicaid recipients. The handbooks provide descriptions and instructions on how and when to complete forms, letters or other documentation.

To request a hard copy of this manual, please contact your Provider Lighthouse Health Plan is a Managed Care Plan with a Florida Medicaid Contract. The process of obtaining approval for reimbursement of a service based on medical necessity. Claim Reimbursement Policy. A policy document that provides. Welcome to the Florida Blue Manual for Physicians and Providers. The Manual is not intended to be a complete statement of all Florida Blue polices or.