Florida Healthy Kids Award
Simply Healthcare Plans, Inc. (Simply) has officially been awarded a Florida Healthy Kids (FHK) statewide contract. Effective January 1, 2020, Simply will offer coverage to FHK-eligible children in all 11 regions, 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.
The FHK plan is designed specifically with kids in mind and provides children with access to the services they need at each unique stage of growth and development. Health services are delivered through our network of local doctors, specialists, hospitals, pharmacies and other health care providers.
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
Medicaid postpartum coverage extension, postpartum optimization, and promoting birth equity
Effective July 1, 2021, Medicaid postpartum eligibility and coverage will extend from 60 days to 12 months post-delivery.
Doula Services
In an effort to improve maternal and child outcomes, Simply Healthcare Plans and Clear Health Alliance have partnered with the National Doula Network to offer doula services to all of our Medicaid members throughout the state.
2021 Provider Satisfaction Survey
2021 Florida Provider Satisfaction Surveys have been mailed out to chosen providers. We want to know what is important to you. If you receive a survey, we highly encourage you to complete it.
Reminder: Authorization requirements for therapy services
Consistent with the Florida Medicaid program’s authorization requirements for therapy services, Simply, CHA and HN1 require the submission of the information and/or documents listed in this document when submitting a request for authorization for therapy services.
In Pursuit of Racial Equity: Deconstructing Bias
Please join us on June 9th to hear from a diverse panel of experienced professionals about racial equity and implicit bias.
Specialty Pharmacy Prior Authorization Retraction Notice
Notification that effective May 1, 2021 specific codes would be included in our prior authorization review process
Medicare updates
2020 SNP Models of Care Annual Evaluations
Axiom to provide lymphedema therapy and management services
Simply Healthcare Plans, Inc. (Simply) has launched a program targeting Medicare Advantage members diagnosed with lymphedema or lymphatic disease. Simply is teaming up with Axiom Rehabilitation
Important Notice CAHPS Reminder
The CAHPS survey is conducted every year from February to June. The survey measures a patient’s experiences and perceptions of their medical care rather than measurable outcomes.
Medicare Advantage — PN for UM AROW Item 1330
On April 1, 2021, Simply Healthcare Plans, Inc. prior authorization requirements will change for the following codes.
Mind, Body, Magic Launches on YouTube
We’re thrilled to announce the launch of our new healthy-living series, Mind, Body, Magic! Hosted by NBA Hall of Famer and our very own Healthcare Advocate, Earvin “Magic” Johnson, the series provides viewers with the information they need to be more confident in managing their health. Over the course of four episodes, Johnson talks with experts from across our state, and country, about a holistic approach to our well-being. Check out the Mind, Body, Magic series on YouTube.
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.
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Need help with Availity? Learn more
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!
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.
