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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Provider and Billing Manual - Ambetter from Sunshine Health

(6 days ago) WEBClaim Reconsiderations Related To Code Editing----- 81 Viewing Claims Coding Edits Ambetter from Ambetter from Sunshine Health PO Box 459089 Fort Lauderdale, FL …

https://ambetter.sunshinehealth.com/content/dam/centene/Sunshine/Ambetter/PDFs/FL2022AmbProviderManual.pdf

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Provider Toolkit Quick Reference Guide - Ambetter from Sunshine …

(5 days ago) WEBUse the Pre-Auth Needed tool on our website to determine if prior authorization is required. Submit prior authorizations via: Secure Provider Portal. External Link. Medical Fax: 1 …

https://ambetter.sunshinehealth.com/provider-resources/provider-toolkit/provider-toolkit-quick-reference-guide.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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Florida Medicaid & Health Insurance Sunshine Health

(1 days ago) WEBA session will be held on June 27, 2024, from 1:30 to 4 p.m. Eastern. Sunshine Health offers affordable Florida Medicaid, Medicare Plans and our Health …

https://www.sunshinehealth.com/

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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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Secure Provider Website - Sunshine Health

(9 days ago) WEBThe Secure Provider Web is a secure website developed to allow Providers across Centene health plans to perform a variety of functions from their office. By registering and …

https://provider.sunshinehealth.com/static/provider/docs/Secure_Provider_Website_Manual_NOV2017.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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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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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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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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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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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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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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Mapping Guides: EDI Claims EDI Blog

(4 days ago) WEBSunshine Health Electronic Claims Guidelines. It is important that providers ensure Sunshine Health has accurate billing information on file. Provider …

https://ediacademy.com/blog/mapping-guides-edi-claims/

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FTC Announces Rule Banning Noncompetes Federal Trade …

(8 days ago) WEBThe FTC estimates that the final rule banning noncompetes will lead to new business formation growing by 2.7% per year, resulting in more than 8,500 additional …

https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-announces-rule-banning-noncompetes

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