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
Important reminder: CAQH updates
In an effort to reduce credentialing and re-credentialing timeframes, it is critical to ensure your CAQH profile is up to date.
Important reminder for home health agencies: Cancelled and rescheduled visits
To avoid no shows, home health agencies are required to notify members and replace the home health aide/nurse if the originally scheduled staff can no longer make the visit.
Legacy Provider Portal update
Effective January 1, 2022, you will no longer be able to access the legacy provider portals.
You're Invited: Buprenorphine use in obstetrical practice CEU/CME opportunity
The Florida Perinatal Quality Collaborative (FPQC) is offering two free continuing medical education (CME) trainings on Buprenorphine use in obstetrical practice.
Application Period for Home and Community-Based Services Provider Funding
Florida Agency for Health Care Administration Announces Application Period for Home and Community-Based Services Provider Funding
Medicare updates
Care for Older Adults - Functional Status Assessment (COA) Measurement Year 2021
We would like to take this opportunity to highlight information about the Care for Older Adults – Functional Status Assessment (COA) measure.
Electronic Medical Record Data Feed Bulletin
Providers using EMR technology can seamlessly increase HEDIS® scores via a secure data feed.
Our new relationship with American Specialty Health
Simply and CHA are contracting with American Specialty Health Group, Inc.* (ASH) to provide quality acupuncture and chiropractic services
Reminder: provider incentive for medication reconciliation
Did you know that Simply pays $25 when a member’s medications post-hospital discharge has been reconciled with the current medication list in outpatient medical record?
2020 SNP Models of Care Annual Evaluations
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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.
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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.
