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Full list of Medical Policies and Clinical Guidelines

WEBMedicaid: 1-844-405-4296 Medicare Advantage: 1-844-405-4297 © 2021 Simply Healthcare Plans, Inc.

Actived: 5 days ago

URL: https://medicalpolicy.simplyhealthcareplans.com/florida-provider/medical-policies-and-clinical-guidelines-full-list

Healthcare Effectiveness Data and Information Set (HEDIS)

WEBThe Healthcare Effectiveness Data and Information Set (HEDIS ®) is a tool used by more than 90% of America’s health plans to measure performance on important dimensions …

Category:  Health Go Health

Member Eligibility and Pharmacy

WEBMember eligibility, panel listings and member reports. Providers can access real-time member eligibility information, member reports and panel listings from the Availity Portal. …

Category:  Health Go Health

Serving Diverse Populations

WEBServing diverse populations Cultural competency resources Tools to help achieve health equity. Patient panels are growing more diverse, and needs are becoming more complex.

Category:  Health Go Health

Simply Healthcare Plans Providers

WEBTo determine if pharmacy benefits are payable by Simply Healthcare Plans, Inc., please confirm the requested services are a covered benefit. Questions about members’ …

Category:  Health Go Health

Reimbursement Policy

WEB07/13/2022 Policy review approved and effective 07/13/2022: Policy language updated (planned readmission/LOA language added), definition section updated to

Category:  Health Go Health

Eligibility & Provider Reports

WEBEligibility and benefits inquiry: To check member eligibility and benefits: From the Availity homepage, select Patient Registration from the top navigation.; Select Eligibility and …

Category:  Health Go Health

Web precertification status and appeals tutorial

WEB1. Choose Select a Provider and select the appropriate provider ID. 2. Enter the appeals submission date range in the Start Date and End Date fields. Use date format …

Category:  Health Go Health

Precertification form notification

WEBMedicare Advantage Provider Bulletin July 2021 Simply Healthcare Plans, Inc. is a Medicare contracted coordinated care plan that has a Medicaid contract with the State of …

Category:  Health Go Health

Pregnancy notification process using the Benefit Look-Up Tool

WEBSimply Healthcare Plans, Inc. Clear Health Alliance Pregnancy notification process using the Benefit Look-Up Tool Page 2 of 3 44 years of age, the system will then display a …

Category:  Health Go Health

Provider Services: https://provider.simplyhealthcareplans.com …

WEBPage 2 of 17 Medicaid Simply Healthcare Plans, Inc. is a Managed Care Plan with a Florida Medicaid contract. Provider Services: 1-844-405-4296 …

Category:  Health Go Health

Taking Care of Baby and Me

WEBWant more information about our obstetrics case management program? Call your Provider Services representative. Meeting our members’ special needs

Category:  Health Go Health

Request for Authorization: Psychological Testing

WEBMedicaid Managed Care Florida Healthy Kids Medicare Advantage Request for Authorization: Psychological Testing * Availity, LLC is an independent company …

Category:  Health Go Health

December 2021 Provider Newsletter

WEBPage 5 of 16 Policy Updates Read more online. Simply Healthcare Plans, Inc. | Medicaid, Florida Healthy Kids, and Medicare Advantage Clear Health Alliance | Medicaid

Category:  Health Go Health

Florida Medicaid Pregnancy Notification Form and provider …

WEBMedicaid Managed Care Provider Bulletin May 2023 * Availity, LLC is an independent company provider administrative support services on behalf of the health plan.

Category:  Health Go Health

Simply Healthcare Plans, Inc. and Lighthouse Health Plan: …

WEBPaper claims. Simply Healthcare Plans, Inc. P.O. Box 61010 Virginia Beach, VA 23466-1010. Electronic claims. https://www.availity.com. Payer ID: SMPLY. Claims for a date of …

Category:  Health Go Health

Telehealth tip sheet (COVID-19)

WEBA visit with a provider that uses telecommunication systems between a provider and a patient. Common telehealth services include: 99201-99215 (Office or other outpatient …

Category:  Health Go Health

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