Sunshine Health Claims Guidelines

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Guidelines for proper claims submissions Sunshine Health

(5 days ago) Guidelines for proper claims submissions effective Oct. 1, 2021. Date: 08/31/21. Fort Lauderdale, Florida. Centene’s acquisition of WellCare's Medicaid products, including Staywell Health Plan, will be complete Oct. 1, 2021. Sunshine Health will also operate the Department of Health’s Children's Medical Services Health … See more

https://www.sunshinehealth.com/newsroom/Guidelines-for-proper-claims-submissions.html

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Clinical & Payment Policies - Ambetter from Sunshine …

(5 days ago) WEBClinical Policies. Clinical policies are one set of guidelines used to assist in administering health plan benefits, either by prior authorization or payment rules. They include but are …

https://ambetter.sunshinehealth.com/provider-resources/clinical-payment-policies.html

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Provider and Billing Manual - Florida - Ambetter from …

(5 days ago) WEBPractice Guidelines ----- 66 Patient Safety and Quality of Care 277CA Health Care Claim Acknowledgement Sunshine Health 1301 International Parkway, Suite 400 …

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

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A Billing and Procedure Coding Guide: Home Health and

(6 days ago) WEBClaim Form. Per the Florida Agency for Health Care Administration (AHCA), Home Health Service providers must bill claims on a CMS-1500 form. Any claims for Home Health …

https://www-es.sunshinehealth.com/content/dam/centene/Sunshine/pdfs/V5%20FINAL%208%208%2016%20Billing%20and%20Procedure%20Coding%20Guide%20vlh.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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Health Provider Manual UPDATED 072513 - www-fl.centene.com

(1 days ago) WEBSUBMIT APPEALS TO: SUBMIT PAPER CLAIMS TO: SUNSHINE HEALTH SUNSHINE HEALTH TANGO PLAN . Attn: Appeals and Grievance Coordinator Attn: …

https://www-fl.centene.com/content/dam/centene/Sunshine/pdfs/SUN_LTC%20Provider%20Manual_20170605.pdf

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PROVIDER QUICK REFERENCE GUIDE

(1 days ago) WEBSunshine Health News Clinical Guidelines Clinical resources on Evidence Base Practices Fraud, Waste and, Abuse Training for Providers CMS 1500/837 Professional, and the …

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

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SUNSHINE STATE HEALTH PLAN, INC. POLICY AND …

(8 days ago) 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 …

https://www-fl.centene.com/content/dam/centene/Sunshine/pdfs/LT-PRVR-03-Provider-Services-and-Complaints.pdf

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Member FAQ - Wellcare

(Just Now) WEBSunshine Health; Language Assistance. A A A. Search. Enter Keyword Search. Information on how to file a claim can be found in the Evidence of Coverage …

https://wellcare.sunshinehealth.com/member-resources/new-members/member-faq.html

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Sunshine Health Overview of Early Intervention Services (EIS) …

(Just Now) WEBIf an EIS or TCM provider has not executed a contract by the time a region is implemented, Sunshine Health will pay EIS or TCM claims from non-participating providers until the …

https://earlysteps.pediatrics.med.ufl.edu/wordpress/files/2019/02/Sunshine-Health-EIS-TCM-Billing-Tip-Sheet-01312019.pdf

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Overview of Billing Guidelines for Early Intervention Services …

(4 days ago) WEBTo file a dispute, a provider can: Call 1-844-477-8313 or Send a written dispute using the Sunshine Health Provider Claim Dispute Request Form to: Sunshine Health PO Box …

https://earlysteps.pediatrics.med.ufl.edu/wordpress/files/2018/12/Overview-EIS-TCM-billing-guidelines-11-29-18.pdf

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FL - Member Reimbursement Medical Claim Form - Ambetter …

(9 days ago) WEBReimbursement will be sent to the Plan subscriber (see Help Sheet for definition) at the address Ambetter from Sunshine Health has on record (To view your address of …

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

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2023 Transparency Notice - Ambetter from Sunshine Health

(1 days ago) WEBMembers or provider can submit a drug exception request to us by contacting Member Services at 1-877-687-1169 (Relay FL 1-800-955-8770), or by sending a written request …

https://ambetter.sunshinehealth.com/resources/handbooks-forms/transparency-notice-2023.html

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MEMBER REIMBURSEMENT MEDICAL CLAIM FORM

(6 days ago) WEB4. Reimbursement will be sent tothe Plan subscriber (see Help Sheet for definition) at the address Ambetter from Sunshine Healthhas on record (To view your address of record, …

https://ambetter.sunshinehealth.com/content/dam/centene/Sunshine/Ambetter/PDFs/FL%20Reimbursement-Form.pdf

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Sunshine Health Overview of Early Intervention Services (EIS) …

(5 days ago) WEBthe time a region is implemented, Sunshine Health will pay MFC claims to MFC parents until the LOA is executed. 6. Timeline of reimbursement from receipt of a clean claim: …

https://floridafapa.org/wp-content/uploads/2019/02/Sunshine-MFC-Billing.pdf

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WellCare and Sunshine Health are joining health plans Wellcare

(1 days ago) WEBIn Florida, WellCare Health Plans and Sunshine Health are bringing our health plans together to better serve our members, providers, partners and …

https://www.wellcare.com/Florida/Providers/Bulletins/WellCare-and-Sunshine-Health

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Health Insurance Portability and Accountability Act of 1996 (HIPAA)

(9 days ago) WEBThe Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient …

https://www.cdc.gov/phlp/php/resources/health-insurance-portability-and-accountability-act-of-1996-hipaa.html

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Examining the facts behind claims in Florida marijuana campaign …

(9 days ago) WEBHere are the claims: 1. “In Florida, marijuana is already available on the streets.”. This is true. While marijuana has been available legally with a prescription in …

https://www.wptv.com/news/state/marijuana/examining-the-facts-behind-claims-in-florida-marijuana-campaign-ads

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Avoid tea, coffee before and after food: ICMR Onmanorama Health

(9 days ago) WEBAt the same time, ICMR advises people to drink tea and coffee without milk, to reduce health risks. The ICMR report also says that the reasons for 56 per cent of the …

https://www.onmanorama.com/lifestyle/health/2024/05/17/coffee-before-after-food-icmr.html

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Potential impact of blood cholesterol guidelines on statin …

(1 days ago) WEBBackground The 2013 ACC/AHA Guideline was a paradigm shift in lipid management and identified the four statin-benefit groups. Many have studied the …

https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-024-03921-z

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