Sunshine Health Authorization Requirements

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Prior Authorization Guide-Florida - Ambe…

(8 days ago) For services or supplies that require prior authorization, as shown on your Schedule of Benefits, you must obtain authorization from us before the you or your dependent member:

https://ambetter.sunshinehealth.com/content/dam/centene/Sunshine/Ambetter/PDFs/AMB-FL_PriorAuthGuide_web.pdf

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Prior Authorization Sunshine Health

(2 days ago) WEBThe number is 1-866-796-0530. Some covered services require a prior authorization from Sunshine Health before the service is provided. The list of services that need a prior …

https://www.sunshinehealth.com/members/LongTermCare/MemberResources/prior-authorization.html

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Provider Toolkit Prior Authorization Guide - Ambetter …

(9 days ago) WEB1-877-687-1169. After normal business hours and on holidays, calls are directed to the plan’s 24-hour nurse advice line. Notification of authorization will be returned by phone, fax or web. FAX. Medical. 1 …

https://ambetter.sunshinehealth.com/provider-resources/provider-toolkit/provider-toolkit-prior-authorization-guide.html

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Provider Quick Reference Guide - Centene

(Just Now) WEBProviders can visit the Sunshine Health website at sunshinehealth.com to access the following: Request Prior Authorization (PA) Contact the Sunshine Health Provider …

https://www-fl.centene.com/content/dam/centene/Sunshine/pdfs/Provider-Quick-Reference-Guide-PDF1.pdf

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How to Secure Prior Authorization - Ambetter from Sunshine …

(Just Now) WEBAfter normal business hours and on holidays, calls are directed to the plan’s 24-hour nurse advice line. Notification of authorization will be returned phone, fax, or web. Emergency …

https://ambetter.sunshinehealth.com/content/dam/centene/Sunshine/pdfs/ProAMB91233PriorAutGuideFL.pdf

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Prior Authorizations Waivers Sunshine Health

(2 days ago) WEBWe are waiving prior authorizations for the following covered services: Hospital-based, ambulatory-surgery center and office-based outpatient procedures …

https://www.sunshinehealth.com/newsroom/prior-authorization-waivers.html

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Outpatient Authorization Form - Ambetter from Sunshine …

(8 days ago) WEBComplete and Fax to: 855-678-6981 Transplant Request Fax to: 833-550-1337. Request for additional units. Existing Authorization. Units. Standard requests - Determination within …

https://ambetter.sunshinehealth.com/content/dam/centene/Sunshine/Ambetter/PDFs/508_EF-PAF-0699_Outpatient_10292020.pdf

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Prior Authorization - Sunshine Health

(7 days ago) WEBPrior Authorization List. CMS Health Plan needs to approve in advance the services listed below. Prior approval is required for all services by a provider who is not in the CMS …

https://www.sunshinehealth.com/members/cms/resources/Prior-Authorization.html

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Provider Manual - Centene

(2 days ago) WEBSunshine Health. SH_ PROVIDER MANUAL Medicaid (MMA), Comprehensive Long Term Care (LTC), Child Welfare Specialty Plan (CWSP) and Serious Mental Illness (SMI) …

https://www-fl.centene.com/content/dam/centene/Sunshine/pdfs/Provider%20Manual.pdf

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Ambetter Prior Authorization Change Summary - Ambetter from …

(7 days ago) WEBAmbetter Prior Authorization Change Summary. Date: 06/21/23. Ambetter from Sunshine Health requires prior authorization (PA) as a condition of payment for …

https://ambetter.sunshinehealth.com/provider-resources/provider-news/ambetter-prior-authorization-change-summary.html

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Radiology Sunshine Health

(4 days ago) WEBThis program is consistent with industry-wide efforts to ensure clinically appropriate quality of care and to manage the increasing utilization of these services. Sunshine Health …

https://www.sunshinehealth.com/providers/Specialty-services/radiology.html

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Prior Authorization Rules for Medical Benefits - Wellcare

(9 days ago) WEBMailing Address - Allwell from Sunshine Health 1301 International Parkway Suite 400 Sunrise, FL 33323; Prior authorization is not a guarantee of payment. Wellcare By …

https://wellcare.sunshinehealth.com/member-resources/member-rights/prior-authorization-medical.html

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PROVIDER QUICK REFERENCE GUIDE

(1 days ago) WEBRequest Prior Authorization (PA) Contact the Sunshine Health Provider Services Department, 8am to 7pm EST, Mon-Fri, at phone 866-796-0530, or fax electronic …

https://physicianscarenetwork.org/images/stories/NEW_Sunshine-quick_reference.pdf

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Authorization to Use and Disclose Health Information - Wellcare

(9 days ago) WEBa. Authorization to Use and Disclose Health Information. Notice to Member: Completing this form will allow Sunshine Health to (i) use your health information for a particular …

https://wellcare.sunshinehealth.com/content/dam/centene/Sunshine/Advantage/PDFs/2020-FL-PHI%20FORM-ALL-MA.pdf

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Provider Resources - Ambetter from Sunshine Health

(7 days ago) WEBIf you need help, call Provider Services at 1-877-687-1169 (Relay Florida 1-800-955-8770) Monday through Friday from 8 a.m. to 8 p.m. Eastern. Stay up to date on Ambetter from …

https://ambetter.sunshinehealth.com/provider-resources/manuals-and-forms.html

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Provider and Billing Manual - Sunshine Health

(2 days ago) WEBThe Health Insurance Marketplace makes buying health insurance easier. The Affordable Care Act is the law that has changed healthcare. The goals of the ACA are: • To help …

https://ambetter-es.sunshinehealth.com/content/dam/centene/Sunshine/Ambetter/PDFs/FL-2021AmbetterPrvdrManual.pdf

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Secure Provider Website - Sunshine Health

(9 days ago) WEBThe Health Record tab allows you to view a record of visits or medications for the patient Care plans are created by the health plan’s case manager to help manage the health.of …

https://provider.sunshinehealth.com/static/provider/docs/Secure_Provider_Website_Manual_NOV2017.pdf

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Prior Authorization, Step Therapy & Quantity Limitations - Wellcare

(4 days ago) WEBQuantity Limits: For certain drugs, we limit the amount of the drug that we will cover. For example, one tablet per day. This may be in addition to a standard one-month …

https://wellcare.sunshinehealth.com/drug-pharmacy/prior-authorization.html

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