In an effort to serve you better, Simply Healthcare Plans provides a Provider Portal for its Simply Medicaid and Medicare lines of business. The following services are available via the Provider Portal:
- Eligibility verification
- Claim Status
- Referral Entry and Status Review
You may register, as a participating provider, on the Simply Provider Portal by entering your Tax Identification Number, NPI and Entity ID (a unique access code generated by Simply Healthcare) as requested on the Registration page of the Web Portal. Please contact Simply via e-mail or by phone in order to obtain the Entity ID.
|Region 11 SHP Miami-Dade & Monroe Directory||February 2015|
Managed Medical Assistance (MMA) Provider Materials
|Provider Manual||May 2014|
|Provider Orientation||May 2014|
|Child Health Check-up Visits Coding Requirements||May 2014|
|Provider Quick Reference Guide||May 2014|
|Request for Services Requiring Prior Authorization||May 2014|
|Pregnancy Notification Form||May 2014|
|OB Provider Pregnancy Assessment Form||May 2014|
|Cultural Competency Plan||September 2014|
|Physician Cultural Competency Independent Training Module||September 2014|
Useful Materials for Medicare Providers
|Medicare Provider Manual||March 2014|
|Provider SNP Model of Care Training||January 2014|
|SNP Model of Care Annual Evaluations for 2013||July 2014|
|Simply Medicare Prior Authorization Form||February 2014|
|SHP Code of Business Ethics||January 2013|
|SHP Medicare Compliance Training||November 2013|
|CMS Medicare Marketing Guidelines||June 2014|
|High Risk Drug Guide||January 2014|
|Simply Medicare Special Needs Plans|
|Waiver of Liability Statement||June 2014|
Prior Authorization Forms
|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||December 2011|
|Informed Consent For Psycotherapeutic Medication (13 years or older)||January 2015|
|AHCA ALERT HIV or Hepatitis C Medications and Statins||July 2012|
|Behavioral Health Screening, Referral, and Coding Requirements Training||February 2015|
|Behavioral Health Screening Coding Requirements||February 2015|
|Diabetes Supplies||January 2015|
|Helping Smokers Quit, A Guide for Clinicians||January 2015|
Health & Wellness Information
Simply Provider Newsletter
Simply Medicare Provider Bulletins
Simply Medicaid Provider Bulletins
Important Provider Notification
Evidence Based Guidelines
PO Box 21535
Eagan, MN 55121
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.
Simply Healthcare is committed to ensuring that its providers are ready for the conversion to ICD-10 on October 1, 2015.
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.
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.