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Health Solutions & Insurance Plans Centene Corporation

WEBFor more than 30 years, Centene has operated government-sponsored healthcare programs that save money and improve medical outcomes. We deliver results for our …

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URL: https://www-fl.centene.com/who-we-are.html

Managed Care & Healthcare Solutions Centene Corporation

WEBCentene's competitive advantage is driven by capability, capacity, scale, and more than 30 years of experience operating government-sponsored healthcare programs. Centene is …

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COMPREHENSIVE Preferred Drug List

WEBExclusions . The following drug categories are not part of the Sunshine Health PDL and are not covered by the 72 hour emergency supply policy: Anti …

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Environmental, Social, Health, and Governance

WEBEnvironmental, Social, Health, and Governance. 2020. Centene is a multi-national healthcare enterprise founded in 1984 on the belief that everyone deserves access to …

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HEDIS Quick Reference Guide

WEBSunshine Health strives to provide quality healthcare to our members as measured through HEDISTM quality metrics. We created this HEDISTM Quick Reference Guide to help …

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Secure Provider Portal Registration

WEBTo register for the Secure Provider Portal, follow the instructions below: Go to www.sunshinehealth.com and select “For Providers” at the top of the page. Select …

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Achieving Whole Health Through Behavioral and Physical …

WEBThe trainings served as a roadmap for education in prescribing buprenorphine until the change in legislation issued by Health and Human Services in April 2021, which …

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Provider Quick Reference Guide

WEBVENDOR SERVICES . MEDICAL MANAGEMENT . The Sunshine Health Medical Management team provides oversight of utilization management, case management and …

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WELCOME TO SUNSHINE HEALTH!

WEBESSENTIAL PROVIDERS Pursuant to s. 409.975(1)(b), F.S., certain providers are statewide resources and essential providers for all Managed Care Plans in all regions.

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2021 Provider Manual

WEB12 September 3, 2020. Provider shall provide services in accordance with Allwell policy: (a) for all members, for the duration of the Allwell contract period with CMS, and (b) for …

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Prior Authorization Request Form

WEBI attest that the medication requested is medically necessary for this patient. I further attest that the information provided is accurate and true, and that documentation supporting this

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SUNSHINE STATE HEALTH PLAN, INC. POLICY AND …

WEBThe Provider Services Representative (PSR) determines if the request is an informal claims adjustment/claim complaint or provider complaint. If it is a complaint the PSR will refer …

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WEBThe 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 …

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Early and Periodic Screening, Diagnosis and Treatment …

WEBEarly. Periodic. Check children’s health at periodic age appropriate intervals. Provide physical, mental, developmental, dental, hearing, vision and other screenings to detect …

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Medicare Inpatient Prior Authorization Fax Form

WEBINPATIENT AUTHORIZATION. For Standard (Elective Admission) requests, complete this form and FAX to 1-877-617-0394. Determination made as expeditiously as the enrollee’s …

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