Medication Alerts from AHCA
All paper claims should be sent to the following new address:
Simply Healthcare Plans
PO Box 21535
Eagan, MN 55121
The forms you download here are viewable using Acrobat Reader.
|Dade - Medicaid Provider Directory||November 2013|
|Orlando - Medicaid Provider Directory||November 2013|
|Polk - Medicaid Provider Directory||November 2013|
|Tampa - Medicaid Provider Directory||November 2013|
Prior Authorization Forms
|Medication Prior Authorization Form - Use for Medicaid and Medicare||February 2012|
|Medication Prior Authorization Fuzeon MEDICAID ONLY||February 2012|
|Medication Prior Authorization HIV-HEP-B Diagnosis Verification MEDICAID ONLY||February 2012|
|Medication Prior Authorization Selzentry Maraviroc MEDICAID ONLY||February 2012|
|Medication Prior Authorization Serostim||February 2012|
|Synagis Request MEDICAID ONLY||February 2012|
Medicaid Prior Authorization & Step Therapy MEDICAID ONLY
The forms you download here are viewable using Acrobat Reader.
|Medicaid Comprehensive Formulary||Sept 2013|
|Informed Consent Form||August 2012|
|OB Provider Pregnancy Assessment Form – Use for Medicaid and Medicare||July 2012|
|Diabetes Supplies||January 2012|
|Simply Exclusive Participating Provider Networks||January 2013|
|Medicaid Provider Handbook||January 2013|
|Medicaid Reform Provider Handbook||January 2013|
|PreAuthorization Form (to be completed by the prescribing physician)||February 2013|
|Helping Smokers Quit, A Guide for Clinicians||February 2012|
|Cultural Competency and Minority Recruitment Plan||August 2012|
Useful Plan Materials for Medicare Providers
Important Provider Notification
- EFT GOES LIVE October 15,2013
- 5010 Readiness Bulletin
- Informed Consent for Psychotherapeutic Medication Update
- Potentially Inappropriate Medication Use in Older Adults: http://media.empr.com/documents/2/ltc-beers_3pt1_1165.pdf
- Printable Pocket Card of Potentially Inappropiate Medication Use in Older Adults: http://www.americangeriatrics.org/files/documents/beers/PrintableBeersPocketCard.pdf
- U.S. Preventive Services Task Force (USPSTF) Recommendations for Adults: http://www.uspreventiveservicestaskforce.org/adultrec.htm
- U.S. Preventive Services Task Force (USPSTF) Recommendations for Children and Adolescents: http://www.uspreventiveservicestaskforce.org/tfchildcat.htm
- Summary of Revisions for the 2012 Clinical Practice Recommendations; Additions to the Standards of Medical Care in Diabetes - 2012: http://care.diabetesjournals.org/content/35/Supplement_1/S11.full
- USPSTF Grade Definitions of Guideline Recommendations: http://www.uspreventiveservicestaskforce.org/uspstf/gradespost.htm#irec
Health & Wellness Information
We Can! (Ways to Enhance Children’s Activity and Nutrition)® is a national public education program to help prevent overweight among youth ages 8-13 through improved food choices, increased physical activity, and reduced screen time sponsored by the National Heart, Lung, and Blood Institute (“NHLBI”), part of the National Institutes of Health (“NIH”), U.S. Department of Health and Human Services (“HHS”) in collaboration with the National Institute of Diabetes and Digestive and Kidney Diseases, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Cancer Institute. http://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/
Promoting Breastfeeding: http://www.uspreventiveservicestaskforce.org/uspstf08/breastfeeding/brfeedrs.pdf
- Folic Acid Supplementation fr Prevention of Neural tube defects in your baby: http://www.uspreventiveservicestaskforce.org/uspstf09/folicacid/folicacidrs.pdf
- National Kidney Foundation KDOGI Guidelines: http://www.kidney.org/professionals/KDOQI/guidelines_ckd/p9_approach.htm.
- Hypertension and Antihypertensive Agents in Chronic Kidney Disease - National Kidney Foundation: http://www.kidney.org/professionals/KDOQI/guidelines_bp/index.htm
- Chronic Heart Failure: ACC/AHA 2005 Guideline update: A report f the ACC/AHA task force on practice guidelines: http://circ.ahajournals.org/content/112/12/e154
- Screening for Bacterial Vaginosis in Pregnancy:http://www.uspreventiveservicestaskforce.org/uspstf08/bv/bvrs.pdf
- Gestational DM Screening: http://www.uspreventiveservicestaskforce.org/uspstf08/gestdiab/gdrs.pdf
For information about diabetes, click www.diabetes.org
Asthma Quick Care Reference Guide, click: http://www.nhlbi.nih.gov/guidelines/asthma/asthma_qrg.pdf
For information about Psychcare go to: http://www.psychcare.com:
For Provider manual click here
Simply Provider Newsletter
Bulletin Volume 1, Issue 2- March 8, 2012 - Simply is Live with Availity
IMPORTANT NOTICE REGARDING Simply Healthcare Plans ELECTRONIC CLAIM SUBMISSION, see Provider Bulletin below
- Bulletin Volume 1, Number 2 - Electronic Claim Submission through EMDEON (UPDATED 04/20/11)
IMPORTANT NOTICE REGARDING Simply Healthcare Plans NEW CORPORATE OFFICE ADDRESS and PO BOX, see Provider Bulletin below
- Bulletin Volume 1, Number 1 - New Corporate Address
Provider Web Portal
In an effort to serve you better, Simply Healthcare Plans has instituted a new Web Portal for its Simply Medicaid and Healthy Kids lines of business. Effective September 27, 2010, you may access the Simply Web Portal. The following services will be available via the Web Portal commencing September 27, 2010:
- Eligibility verification
- Claim Status
- Referral Entry and Status Review
You may register, as a participating provider, on the new Simply Web Portal by entering your Tax Identification Number and NPI as requested on the Registration portion of the Web Portal. Please contact Simply via e-mail should additional assistance be required.
Evidence Based Guidelines
A copy of the guidelines are available upon request by calling the Provider Services number.
Phone: (877) 915-0551
Eligibility Verification System
For membership eligibility and verification, call our DIgital Voice Assistant at (877) 915-0551.
Enter Member's Medicaid ID or Member's Healthplan ID as it appears on their ID card.
Problems? Dial 0 to speak with a representative.
ICD-10 Readiness Assessment Survey
How Ready Are You? Find out in minutes.
Online now through 09/15/2013
Simply Healthcare is committed to ensuring that its providers are ready for the conversion to ICD-10 on October 1, 2014.
To support you throughout the ICD-10 conversion process, we have designed a brief Readiness Assessment Survey. Completion of the 26-question survey will help us establish a baseline measure of your readiness and guide us in assisting you though a successful ICD-10 conversion. You may access the survey online now through 09/15/13.
We appreciate your participation in the Simply Healthcare ICD-10 Readiness Assessment Survey and look forward to working with you to ensure a smooth conversion.