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
Dade - Medicaid Provider DirectorySeptember 2014
  

Prior Authorization Forms

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 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/
Folic Acid Supplementation fr Prevention of Neural tube defects in your baby: http://www.uspreventiveservicestaskforce.org/uspstf09/folicacid/folicacidrs.pdf
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
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.