Medicaid sunshine health.

Medicaid is a government program that provides healthcare coverage to low-income individuals and families. However, not everyone is eligible for Medicaid. One of the key factors in...Members may call Sunshine Health to select and/or change their PCP assignment at any time. Members may also request language assistance or help with other issues. Member Services Medicaid/Long Term Care: 1-866-796-0530 (TTY 1-800-955-8770) Child Welfare Specialty Plan: 1-855-463-4100 (TTY 1-800-955-8770)Services must be medically necessary in order for us to pay for them. CMS Health Plan might not cover some services, but Medicaid might still cover them. To find out about these benefits, call the Agency Medicaid Help Line at 1-877-254-1055. If your child needs a ride to any of these services, we can help.Potential Fraud, Waste or Abuse reporting may be called to Sunshine Health's anonymous and confidential hotline at 1-866-685-8664 or by contacting the Compliance Officer at 1-866-796-0530.You may also send an email to [email protected] To report suspected fraud, waste, abuse, or neglect …Sunshine Health offers many convenient and secure tools to assist you. You also have access to your healthcare information. To enter our secure portal, click on the login button. A new window will open. You can login or register. Creating an account is free and easy. By creating a Sunshine Health account, you can: Change your Primary Care Doctor.

But please note, some of the content is designed especially for our Sunshine Health Medicaid members and new mothers to help them make the most of Sunshine Health benefits and services. State Medicaid coverage was recently extended to allow women to keep Medicaid for 12 months after giving birth. You can also read ahead by clicking the …

Contacting Member Services. You may call us at 1-866-799-5321 (TTY 1-800-955-8770) Monday through Friday, 8 a.m. to 8 p.m. Eastern but not on state approved holidays like Christmas Day and Thanksgiving Day. When you call, make sure to have your child’s identification card (ID card) so we can help. If the ID card is lost or stolen, call Member ...

What You Can Do. Write us or call us at any time. 1-866-796-0530 (phone) or TTY at 1-800-955-8770. Call us to ask for more time to solve your grievance if you think more time will help. You can contact us at: Sunshine Health. P.O. …EPSDT Program (Well Child Care) EARLY: Assessing and identifying problems early. PERIODIC: Checking children’s health at periodic, age-appropriate intervals. SCREENING: Physical, behavioral, developmental, dental, hearing, vision and other screening tests to detect potential problems. DIAGNOSTIC: Tests to follow up when a risk is identified. Call our Member Services department toll-free at 1-866-796-0530 ( TDD/TTY 1-800-955-8770) if you have questions about transitioning your care. Sunshine Health is committed to providing the best possible care. Learn how to switch health care plans and keep your doctor with Sunshine Health. 4. Be Proactive, and Don’t Panic. One study found the risk of colon cancer for adults born in 1990 is twice that of an adult born in 1950. But the risk is still a small one. …

Members may call Sunshine Health to select and/or change their PCP assignment at any time. Members may also request language assistance or help with other issues. Member Services Medicaid/Long Term Care: 1-866-796-0530 (TTY 1-800-955-8770) Child Welfare Specialty Plan: 1-855-463-4100 (TTY 1-800-955-8770)

Sunshine Health is a managed care plan with a Florida Medicaid contract. The benefit information provided is a brief summary, not a complete description of benefits. Limitations, co-payments and restrictions may apply.

They also help make sure your baby is growing and developing properly. It’s important to see a doctor if you are planning on becoming pregnant, or as soon as you know you are pregnant. If you need help finding an OB-GYN, we can help. Use our Find a Provider tool or call Member Services at 1-855-463-4100. CMS Health Plan might not cover some services, but Medicaid might still cover them. To find out about these benefits, call the Agency Medicaid Help Line at 1-877-254-1055. If your child needs a ride to any of these services, we can help. Please call MTM at 1-844-399-9469 to schedule a ride at no cost to you. Contacting Member Services. You may call us at 1-866-796-0530, or TTY at 1-800-955-8770, Monday through Friday, 8 a.m. to 8 p.m., but not on state approved holidays (like …1-866-796-0530 (TTY 1-800-955-8770) Press 1 for Member. Press 2 for LTC or 3 for MMA. Press 5 for Nurse Advice Line. Email Sunshine Health. [email protected]. Include your child’s name, Medicaid ID number and home health provider, the date and time of the shift missed, and your …We can provide rides to your child’s medical appointments at no cost. Medical Transportation Management (MTM) provides transportation for Children’s Medical Services Health Plan (CMS Health Plan) members. There are no limits to the number of trips during the year between medical appointments, healthcare …We can provide rides to your child’s medical appointments at no cost. Medical Transportation Management (MTM) provides transportation for Children’s Medical Services Health Plan (CMS Health Plan) members. There are no limits to the number of trips during the year between medical appointments, healthcare … Sunshine Health is a managed care plan with a Florida Medicaid contract. The benefit information provided is a brief summary, not a complete description of benefits. Limitations, co-payments and restrictions may apply.

Mammograms: Regular breast cancer screenings are key for women’s health. They have can cut the risk of dying of breast cancer by nearly 40%. According to the American Cancer Society, It is recommended that most woman should start getting mammograms every other year at age 40 and then every year at age 45. For …2. Receive a letter to choose a plan. 3. Choose a plan. 4. Call a Choice Counselor toll-free at 1-877-711-3662 (TTY 1-866-467-4970) or visit the Statewide Medicaid Managed Care page online. 5. Receive a welcome packet from your plan. CHOOSE SUNSHINE HEALTH.Use our Find a Provider tool or call Member Services at 1-866-796-0530. Please let us know when you are pregnant by logging in to your secure member portal account and filling out …Sunshine Health’s Healthy Behaviors program aims to help members improve their health and wellness. The program also helps members manage chronic conditions and build relationships with their providers. Known as My Health Pays, the program lets members earn dollar rewards by completing healthy activities. Read the full 2022-2023 evaluation (PDF).ModivCare serves as Sunshine Health’s administrator for all non-emergent transportation operations for Medicaid, Child Welfare and Serious Mental Illness plans. This includes verifying the member’s eligibility, trip purpose and mode of transportation. The following transportation services are offered at no cost to …

Ages 50-74 years: Complete annual mammogram screening. $20: HRA completion. Completion of HRA for new members within 60 days of enrollment. $20: HPV vaccine series. Ages 13-26 years. Complete 2-3 doses human papillomavirus (HPV) vaccine. $20: TDAP for pregnant women.

DME Fax to: 833-741-0943 HH Fax to: 866-534-5978 BH: Fax 844-208-9113. Urgent requests - Please call 1-844-477-8313. *Urgent requests are made when the member or his/her physician believes that waiting for a decision under the standard timeframe could place the enrollee’s life, health, or ability to regain maximum function in …Choose or change your provider in your private, online account. If you have any questions, we’re here to help Monday through Friday, 8 a.m. to 8 p.m. You can call us at any time, even after business hours, to reach our 24-hour Nurse Advice Line. 1-866-796-0530 ( TTY 1-800-955-8770)Renewing your Medicaid eligibility is as easy as 1, 2, 3. You should receive a letter in a yellow striped envelope from the Florida Department of Children and Families (DCF) 45 days before your Medicaid anniversary, explaining how to verify your Medicaid eligibility. If you are eligible for Medicaid, you can continue your Sunshine Health ...Sunshine Health Child Welfare Specialty Plan Benefits to help you and your family. $25 Over-The-Counter Benefit: $25 provided per household per month to buy products like cough, cold and allergy medications, first aid supplies and vitamins. View the Over-the-Counter Health and Wellness Catalog (PDF) to find products.Jan 1, 2024 · Sunshine Health is a licensed Florida health plan. Eligibility. The CMS Health Plan is for children who: Are under age 21 and eligible for Medicaid and; Have special healthcare needs that require extensive preventive and ongoing care; The need for preventive and ongoing care could mean working with several different providers at once. Sunshine Health is the largest Medicaid managed care organization in Florida. As a Behavioral Health Provider for Sunshine Health, you also have an opportunity to serve our specialty populations, such as members in our Serious Mental Illness (SMI) Specialty Plan, Child Welfare (CW) Specialty Plan and Children’s Medical Services (CMS) Health Plan. Get acces to year …Are you considering retiring on the beautiful Sunshine Coast? With its stunning beaches, vibrant communities, and year-round sunshine, it’s no wonder this region is a popular choic...Here's What Floridians on Medicaid Need to Know About Redetermination. Date: 04/03/23 Fort Lauderdale, Florida. As a leading Medicaid managed care provider in Florida, Sunshine Health is committed to ensuring Florida residents have access to high-quality, affordable health coverage. In line with its mission, Sunshine …Home Health Services. Nursing services and medical assistance provided in your home to help you manage or recover from a medical condition, illness or injury. We cover, when medically necessary: Up to 4 visits per day for pregnant recipients. Up to 3 visits per day for all other recipients. Prior Authorization Required.Sunshine Health is committed to providing appropriate, high quality, and cost-effective care to our members. Some products may require prior authorization (PA) or have limitations on maximum quantities. For the most current information about the Sunshine Health Pharmacy Program, you may call Provider Services at 1-844-477-8313 or visit Pharmacy ...

Dec 31, 2012 ... The Company provided managed health care benefits and services to Medicaid and long-term care members pursuant to agreements with the ...

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Call 1-800-950-6264. Monday through Friday, 10 a.m. to 10 p.m. ET. Sunshine Health’s 24-hour Behavioral Health Crisis Line offers trained professionals to help you or a loved one cope with mental health challenges. Call 1-855-463-4100 (TTY 1-800-955-8770) We are here 24/7, including weekends and holidays. Find a provider on our Find a ... If you need help finding an in-network provider, please call Member Services at the number on the back of your ID card. We will help you. Sunshine Health exists to improve the health of its beneficiaries through focused, compassionate and coordinated care. Find a provider today.1-866-796-0530 (TTY 1-800-955-8770) Press 1 for Member. Press 2 for LTC or 3 for MMA. Press 5 for Nurse Advice Line. Email Sunshine Health. [email protected]. Include your child’s name, Medicaid ID number and home health provider, the date and time of the shift missed, and your …Sunshine will take whatever steps are necessary to ensure that the provider is recognized by the state Medicaid program, including the enrollment broker contractor(s) as a participating provider of Sunshine Health Plan, and, that the provider’s submission of encounter data is accepted by the Florida MMIS and/or the state’s encounter data …Get Rides to Medical Appointments – At No Cost to You. To make it easy for you to get healthy and stay healthy, Sunshine Health provides rides to your medical appointments at no cost to you. There are no limits to the number of trips that you may schedule during the year to take you to medical appointments, healthcare facilities or pharmacies ... Sunshine Health notifies providers in advance of a medical record review. A score of eighty-percent (80%) with at least five of the six core NCQA standards must be met to receive a passing score (core standards are marked with an asterisk). At a minimum, each medical record must be legible and maintained in detail with the following ... Private Duty Nursing (PDN) Real-Time Reporting Process. We want to ensure that your child is receiving the services required to keep them safe in your home. Please contact Sunshine Health right away when a Private Duty Nursing shift is missed. Learn how to reach us: Medicaid (MMA) Long Term Care (LTC) Serious Mental Illness (SMI) Specialty Plan.Sunshine Health Medicaid (MMA) Long Term Care (LTC) Serious Mental Illness (SMI) Specialty Plan; Child Welfare Specialty Plan (CWSP) Children's Medical Services (CMS) Health Plan; The new ID card will be effective January 1, 2024. We are sending members a new card for 2024 because we updated the pharmacy …Take advantage of Sunshine Health ’s Quality Improvement Program and develop your preventative health plan today. Visit us online. ... Medicaid HEDIS Rates for Calendar Year 2016 and 2017. Adult Measures 2016 2017; Adult BMI Assessment: 84.62%: 87.35%: Adults Access to Preventive/Ambulatory health Services: 66.89% : 68.87%: Childhood …

Register Now for Provider Specific Town Hall Sessions. Learn about important updates and policy changes that affect your practice and your business. Sunshine Health offers affordable Florida Medicaid and health insurance. Visit our Newsroom online to stay updated on recent Florida Medicaid news.Feb 16, 2024 · Sunshine Health is a managed care plan with a Florida Medicaid contract. The benefit information provided is a brief summary, not a complete description of benefits. Limitations, co-payments and restrictions may apply. Children's Medical Services Health Plan Provider Directory - Region 3 (PDF) Serving Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee and Union counties. Children's Medical Services Health Plan Provider Directory - Region 4 (PDF)date of service, member name and date of birth or the Medicaid ID number and date of birth. o Ensure you’re selecting the correct plan type. • Alternatively, you can call Provider Services at 1 -844-477-8313. Supply the member’s name and date of birth or the member’s Medicaid identification number and date of birth.Instagram:https://instagram. sav bankservices.planning centerbackgammon live facebookmagic drawing TNFL administers therapy services at outpatient free standing facilities for Sunshine Health’s Medicaid (MMA), Serious Mental Illness (SMI) Specialty Plan and Child Welfare (CW) Specialty Plan members ages 3 years and above enrolled in Sunshine Health. Members ages 0-2 years old are managed by Sunshine Health. The following services are ... Your Medicaid Benefits. Your Medicaid Expanded Benefits. Your Behavioral Health Enhanced Benefits. Learn about Benefits and Services available from Sunshine Health … home base appsoul plane movie Sunshine Health Website . Florida Medicaid Web Portal. here* Sunshine Health Website . For Providers. Provider Resources. Provider Training. Sunshine Health Website . 1-866-796-0530 TDD/TTY 1-800-955-8770 SunshineHealth.com HOME CARE COVERED SERVICES The codes listed below are not a complete list. Please refer to your contract … jira data center Contacting Member Services. You may call us at 1-866-796-0530, or TTY at 1-800-955-8770, Monday through Friday, 8 a.m. to 8 p.m., but not on state approved holidays (like Christmas Day and Thanksgiving Day). When you call, make sure you have your identification card (ID card) with you so we can help you. If you lose your ID card, or if it is ... Oct 1, 2013 ... Sunshine Health provides healthcare services to Medicaid, Healthy Kids, Long Term Care and Medicare D-SNP members in Florida. The health ...Gov. Ron DeSantis on Thursday signed a package of bills that supporters say will help improve access to health care, boost the number of doctors in Florida and …