Florida Healthy Kids
Simply Healthcare Plans, Inc. (Simply) offers coverage to FHK-eligible children in all 11 regions of Florida, representing 67 counties.
FHK’s mission is to ensure the availability of child-centered health plans that provide comprehensive, quality health care services. The program has a subsidized plan for children ages 5 through the end of age 18 whose families exceed the income eligibility threshold for Medicaid, as well as full-pay options available for those who don’t qualify for subsidized coverage
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/Florida Healthy Kids updates
Hurricane Ian - Authorization Waivers and Pharmacy Updates
Due to Hurricane Ian, the Governor of Florida has issued a state of emergency for all counties under Executive Order 22-291. For more information on prior authorizations and pharmacy updates, refer to the bulletin(s) listed below.
Register Today: Continuing to Explore the Intersection of Race and Disability
Register today for the Exploring the Intersection of Race and Disability forum hosted for providers on September 21, 2022. We believe that continuing the discussion we started at our June 2022 event to deepen the conversation about the disability experience for people of color is critically important.
This is Quitting - Help Teens Quit Vaping
This is Quitting is a program to help young people quit vaping. Learn more about how it works and the additional resources available for parents of young vapers.
Simply Medicaid Acquisition Region 8
Simply is finalizing the SMMC MMA contract acquisition of Vivida Health and expanding its SMMC MMA footprint in region 8 as a non-specialty SMMC MMA plan. Pending the Agency for Health Care Administration’s (AHCA) review and approval, Simply is expected to start serving the healthcare coverage needs of Vivida members on November 1, 2022.
Review NPI/Taxonomy on Claims and the PML!
Providers need to review their claim submission process and their taxonomy on the state PML. When the taxonomy is not present or does not match what is on the state PML, the validation of the claim/encounter stops and will be rejected.
Medicare updates
Hurricane Ian - Authorization Waivers and Pharmacy Updates
Due to Hurricane Ian, the Governor of Florida has issued a state of emergency for all counties under Executive Order 22-291. For more information on prior authorizations and pharmacy updates, refer to the bulletin(s) listed below.
Register Today: Continuing to Explore the Intersection of Race and Disability
Register today for the Exploring the Intersection of Race and Disability forum hosted for providers on September 21, 2022. We believe that continuing the discussion we started at our June 2022 event to deepen the conversation about the disability experience for people of color is critically important.
Register today: Exploring the intersection of race and disability
Simply is committed to making healthcare simpler and reducing health disparities. Open discussion about the disability experience for people of color and reducing implicit bias for those in healthcare is critical to improving the health and well-being of the communities in which we live and serve — all Americans.
Hospitalist Group Update Bulletin
Please refer to the Hospitalist Group Update Bulletin for information on changes made to our preferred hospitalist groups in Miami-Dade, Broward and Palm Beach counties.
2021 SNP Models of Care Annual Evaluations
Under the Medicare Modernization Act of 2003 (MMA), Congress created a new type of Medicare Advantage coordinated care plan focused on individuals with special needs. Special Needs Plans (SNPs) were allowed to target enrollment to one or more types of special needs individuals identified by Congress as: 1) institutionalized and/or institutionally equivalent; 2) dually eligible; and/or 3) individuals with severe or disabling chronic conditions.
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Please visit the Availity portal.
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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!
Receive email from Simply
Simply is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email.
Featured resources
Pharmacy Information
Search for up-to-date drug information, including hundreds of brand-name and generic medications.
Maternal Child Program
When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. We encourage all our moms-to-be to take part in the Taking Care of Baby and Me® program, a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.
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.
