Provider Services

Provider Portal

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 and NPI as requested on the Registration page of the Web Portal. Please contact Simply via e-mail should additional assistance be required.


Managed Medical Assistance (MMA) Provider Materials

TitleLast Updated
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 SerostimFebruary 2012
Synagis Request (MEDICAID ONLY)February 2012
Medicaid Prior Authorization & Step Therapy MEDICAID ONLYDecember 2011

Downloads

TitleLast Updated
Informed Consent FormAugust 2012
OB Provider Pregnancy Assessment Form – Use for Medicaid and MedicareJuly 2012
Diabetes SuppliesJanuary 2012
Helping Smokers Quit, A Guide for CliniciansFebruary 2012

Health & Wellness Information

We Can! Ways to Enhance Children's Activity & Nutrition
We Can! is a national movement designed to give parents, caregivers, and entire communities a way to help children 8 to 13 years old stay at a healthy weight. For more information, click here

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


Psychcare

For information about Psychcare go to: http://www.psychcare.com:
For Provider manual click here

Simply Provider Newsletter


Simply Medicare Provider Bulletins


Simply Medicaid Provider Bulletins

Bulletin Volume 1, Issue 1- Jan.1, 2012 - In Office Lab Services Reimbursement Begins for Medicaid FFS PCP’s
Bulletin Volume 1, Issue 2- March 8, 2012 - Simply is Live with Availity
Bulletin Volume 1, Issue 3- Sept. 26, 2012- Vaccines for Children
Bulletin Volume 1, Issue 4- Nov.1, 2012- Pharmacy Notice
Bulletin Volume 1, Issue 5- Dec. 1, 2012- Provider Portal Enhancements
Bulletin Volume 1, Issue 6- Jan. 1, 2013- AAAHC
Bulletin Volume 1, Number 2 - Electronic Claim Submission through EMDEON (UPDATED 04/20/11)
Bulletin Volume 1, Number 1 - New Corporate Address 

Evidence Based Guidelines

A copy of the guidelines are available upon request by calling the Provider Services number.

Medication Alerts from AHCA

AHCA Alert - HIV or Hepatitis C Medications and Statins - July 2012

Claims Submission

All paper claims should be sent to the following new address:

Simply Healthcare Plans
PO Box 21535
Eagan, MN 55121

Provider Contact

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. 

Provider Readiness Survey

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.