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, 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.


Provider Directory

TITLELAST UPDATED
Region 11 SHP Miami-Dade & Monroe DirectoryFebruary 2015

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
Informed Consent For Psycotherapeutic Medication (13 years or older)January 2015
AHCA ALERT HIV or Hepatitis C Medications and StatinsJuly 2012

Provider Trainings

TITLELAST UPDATED
Behavioral Health Screening, Referral, and Coding Requirements TrainingFebruary 2015
Behavioral Health Screening Coding RequirementsFebruary 2015

Downloads

TitleLast Updated
Diabetes SuppliesJanuary 2015
Helping Smokers Quit, A Guide for CliniciansJanuary 2015

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
 
Useful tools: 

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


Evidence Based Guidelines

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

Claim 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.