Simply Healthcare Provider Home

Providers

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

Post Hurricane Dorian Provider Notice

Now that the hurricane has moved past Florida and we begin returning to normal business operations, the following flexibilities/waivers offered to providers in the alert issued on August 30, 2019, expired on 11:59 p.m. on Sunday, September 8, 2019.

Florida Surgeon General Scott A. Rivkees Issues Public Health Emergency in Response to Hepatitis A Outbreak

The Florida Surgeon General Dr. Scott Rivkees declared a Public Health Emergency to address the increase in Hepatitis A cases in Florida due to the current national outbreak. For questions about Hepatitis A, the Florida Department of Health has established a dedicated email address: HepA@flhealth.gov, and information line: 1-844-CALL-DOH (1-844-225-5364), available Monday – Friday, 8 a.m. – 5 p.m.

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.

Electronic claim payment reconsideration

Currently, providers can submit claim payment reconsideration requests verbally, in writing or electronically. We are reaching out to notify you about some exciting, new tools for electronic submission of Medicaid claims that will become available through the Availity Portal. You should soon see changes in your provider manual that will outline this new information. Beginning July 22, 2019, providers will have the ability to submit claim reconsideration requests through the Availity Portal with more robust functionality.

Medicare updates

Post Hurricane Dorian Provider Notice

Now that the hurricane has moved past Florida and we begin returning to normal business operations, the following flexibilities/waivers offered to providers in the alert issued on August 30, 2019, expired on 11:59 p.m. on Sunday, September 8, 2019.

Florida Surgeon General Scott A. Rivkees Issues Public Health Emergency in Response to Hepatitis A Outbreak

The Florida Surgeon General Dr. Scott Rivkees declared a Public Health Emergency to address the increase in Hepatitis A cases in Florida due to the current national outbreak. For questions about Hepatitis A, the Florida Department of Health has established a dedicated email address: HepA@flhealth.gov, and information line: 1-844-CALL-DOH (1-844-225-5364), available Monday – Friday, 8 a.m. – 5 p.m.

Please see here for more information:

MMP Pharmacy benefit manager change to IngenioRx

Effective January 1, 2020, IngenioRx will become our new pharmacy benefit manager (PBM) and will start managing prescription coverage for your Medicare Advantage individual and group retiree plan patients. IngenioRx PBM services will include handling your patients’ prescriptions for mail order and specialty pharmacy medications.

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


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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.