Simply Healthcare Provider Home


Welcome, providers!

Resources that help health care professionals do what they do best — care for our members.

At Simply Healthcare Plans, Inc. (Simply), we value you as a provider in our network. That's why we’ve redesigned the provider site to make it more useful for you and easier to use.

Looking for the secure portal?

For Medicaid services provided before the rollout of the new Statewide Medicaid Managed Care and Managed Medical Assistance contract or Medicare services providers before January 1, 2019, please visit the previous Simply provider portal.

For services provided after the new Medicaid and Medicare plan rollouts, please visit the Availity portal.

Don't have an Availity account? Register for free now!

Need help with Availity? Learn more

Provider news

The latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more.

Medicaid updates

Healthy Behaviors Annual Evaluation 2019

The purpose of the Healthy Behaviors Rewards Program is to provide members with programs that encourage and reward healthy behaviors designed to improve the enrollee's overall health. (s.409.973 (3), F.S).

Electronic Visit Verification (eVV) Effective December 1, 2019

Simply Healthcare Plans Inc. (Simply) is implementing an Electronic Visit Verification (EVV) system. Tellus eVV is a technology provider that collaborates with Simply. Starting December 1, 2019 all statewide Medicaid Managed Care Medical Assistance (SMMC MMA) services in Florida, including personal and home health services, must be submitted through the Tellus eVV system.

Please see here for more information:

Pharmacy benefit manager change to IngenioRx

Effective October 1, 2019, IngenioRx will become the pharmacy benefit manager (PBM) for prescription drugs, home delivery pharmacy and specialty pharmacy for Simply Healthcare Plans, Inc. and Clear Health Alliance (Simply) members.

Medicare updates

Pharmacy Benefit Manager Change to IngenioRx - Effective 1/1/2020

Earlier this year, Simply Healthcare Plans, Inc. announced the launch of IngenioRx, our new pharmacy benefits manager (PBM). Effective January 1, 2020, IngenioRx will start serving our members with Medicare Part D prescription drug coverage.

New Medicare Beneficiary Identifier notice

CMS mailed out new Medicare cards without SSNs to offer better identity protection.

Providers can help protect their patients' identities by using the Medicare Beneficiary Identifier (MBI) for Medicare business, including claims submission and eligibility transactions.

For more information about this update, please visit this page.

Availity access

The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer.

At Availity, you can:

Request Authorizations.
Submit Claims.
Confirm Eligibility.

Don't have an Availity account? Register for free now!

Availity is your one-stop to complete your transactions

Featured resources

Pharmacist looking at prescription bottle

Pharmacy Information

Search for up-to-date drug information, including hundreds of brand-name and generic medications.

Expectant mother sharing ultrasound

Maternal Child Program

We offer a proactive case-management program for expectant mothers and their newborns. The My Advocate™ program provides pregnant women with proactive outreach and education through interactive voice response (IVR), text or smartphone application.

Patient talking with counselor

Behavioral health provider

We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.

NCQA Health Plan Recognition

The National Committee for Quality Assurance has awarded an accreditation status of Accredited for service and clinical quality that meets the basic requirements of NCQA’s rigorous standards for consumer protection and quality improvement.

NCQA Health Plan Accreditation surveys include rigorous on-site and off-site evaluations of over 60 standards and selected HEDIS® measures. A team of physicians and health plan experts conducts accreditation surveys. A national oversight committee of physicians analyzes the team’s findings and assigns an accreditations level based on the performance of each plan being evaluated to NCQA’s standards.

Provider survey

We want to hear from you! Please help us improve our provider website by taking this brief survey.

Provider tools & resources

Interested in becoming a provider in the Simply network?

We look forward to working with you to provide quality service for our members.