Provider Web 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
|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|
Useful Materials for Medicare Providers
|Medicare Provider Manual||January 2013|
|Provider SNP Model of Care Training||January 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|
|Dade - Medicaid Provider Directory||July 2014|
|Orlando - Medicaid Provider Directory||July 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 Form||August 2012|
|OB Provider Pregnancy Assessment Form – Use for Medicaid and Medicare||July 2012|
|Diabetes Supplies||January 2012|
|Helping Smokers Quit, A Guide for Clinicians||February 2012|
|Cultural Competency and Minority Recruitment Plan||June 2013|
Health & Wellness Information
Simply Provider Newsletter
Simply Medicare Provider Bulletins
Simply Medicaid Provider Bulletins
Bulletin Volume 1, Issue 2- March 8, 2012 - Simply is Live with Availity
Important Provider Notification
Evidence Based Guidelines
Medication Alerts from AHCA
All paper claims should be sent to the following new address:
Simply Healthcare Plans
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.