For more information contact the Managed Care Plan. In addition, we will continue hosting virtual Provider Town . One-person household: $10 per month. Healthy behaviors include taking care of medical needs, cutting out habits that hurt your health and getting regular preventive screenings. Don't have an account yet? The important thing to know is that members do not need to take any action. CarePlus is here to help you enjoy a rewarding journey. To register for an upcoming Town Hall or watch a recording of a previous Town Hall, please visit our Provider Training web page. That means you get more than just access to a large network of quality physicians. We are excited to announce the integration of Sunshine Health and WellCaresProvider Engagement teams. Call1-866-255-4549(TTY users call1-800-323-9121) 24 hours a day, 7 days a week for more informationorvisitLifeStation.com. Please include your Tax ID and Name when reaching out. Health Insurance Marketplace plans through its Ambetter brand. Stay tuned to this webpage where you can find all the integration information in one place. To emphasize the importance of healthy behaviors, CMS Health Plan members choosing to improve health receive a reward after completing one of the healthy behavior programs. If you're interested in making healthy lifestyle changes, we'll help you connect with other resources covered by . Sunshine Health is a managed care plan with a Florida Medicaid contract. Sunshine Health is a licensed Florida health plan. Pediatric Therapy Provider Access Contact Provider Complaints Risk Adjustment Coding Guidelines Provider Training EPSDT Provider Training Fraud, Waste and Abuse Model of Care Provider Training Opioid Training Toolkit Quality Improvement CAHPS Corner Gaps in Care Medical Records Requirements Practice Guidelines Providing Quality Care Resource Guides Florida | Wellcare In regions where both Sunshine Health and WellCare of Florida offer Medicaid plans, we will continue to apply the rates in the respective contracts for the corresponding membership. Some of the items that you can get through theOTC4MeDiscount Program are listed below: Here are some details on how you can get started with theOTC4MeDiscount Program: LifeMart gives you access to thousands of deals on nationally recognized brand-name products and services all in one convenient location. You will need Adobe Reader to open PDFs on this site. We will continue to operate all lines of business as we did prior to the transaction closing. Wellcare is part of Centene Corporation, the sixth-largest provider of Medicare Advantage plans. Box 31372,Tampa, FL 33631-3372, DOS or Discharge after Oct. 1Online:Sunshine Health, DOS or Discharge after Oct. 1 paper:Sunshine Health,P.O. Through the Healthy Rewards Program you are eligible for 1 Fitbit Inspire 2 device at no cost to you! Browse major savings on the go. Introducing My Wellcare Rewards: A Refreshed Member Rewards Program The Medicare plans represented are PDP, HMO, PPO or PFFS plans with a Medicare contract. The latest edition of Wellcare Insider, your source for important updates and reminders to help you provide excellent service and grow your business. The benefit information provided is a brief summary, not a complete description of benefits. Sunshine Health operates as Statewide Medicaid Managed Care (SMMC) Managed Medical Assistance (MMA), Long Term Care (LTC) and a Child Welfare Specialty Plan (CW) in all regions through a contract with the Agency for Health Care Administration (AHCA). on everything from computers to car rentals, gifts to groceries, electronics to entertainment, and much more. Sunshine Health and WellCare of Florida will provide advance notice to our providers and members of any future changes to our brands or provider/member materials. In addition: The American Medical Association published vaccine-specific CPT codes to report immunizations for COVID-19, and CMS published billing guidance for Medicaid and CHIP providers. During the transition period, each contract will continue to preserve its rates and serve the same membership it has always served. Create an online account, search for vendors and get discount offers to use at your convenience. ET, Sat Sun 10a.m. 7p.m. We will continue to operate in the same way, offer the same services, cover the same members and honor the same provider contracts, as we have in the past. THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF INSPECTOR GENERAL IS ALERTING THE PUBLIC ABOUT A FRAUD SCHEME INVOLVING GENETIC TESTING. After October 1, 202, ALFs will not require authorization. Allwell Member Rewards Program Has Changed - Healthy Rewards - CareValue Service authorizations are coordinated between the member and the members POA. Member Eligibility Claims adjustments Authorizations Escalations You can even print your chat history to reference later! We welcome Brokers who share our commitment to compliance and member satisfaction. 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. We encourage you to take advantage of this easy-to-use feature. Including an annual wellness visit, flu shot and many more services. The above Healthy Activities are eligible for rewards. As a Capital Blue Cross member, you have access to Healthy Blue Rewards at no cost to you. The information on this website is for agent use only and not intended for the general public. Wellcare members get access to LifeMart at no cost! Home For Providers For Brokers Dear Provider, Meridian, MeridianComplete (Medicare-Medicaid Plan), Ambetter from Meridian, and Wellcare are pleased to announce our 2022 Provider Incentive Programs, effective January 1, 2022. The majority of our contractual notices have been mailed. 2023 Medicare and PDP Compare Plans and Enroll Now. My Wellcare Rewards program participation: This program is designed to close care gaps; therefore, it is not a claims-based program. We cover prescription medications and certain over-the-counter medications with a written order from a Sunshine Health provider. Sunshine Health and WellCare of Florida Provider Manuals will continue to apply to the operation of each plans existing contracts. If you are interested in getting support building a nutritionally based diet, consider scheduling a session with a . Florida Medicaid Options & Plans | Sunshine Health The sessions are completed over the phone to fit your schedule. No, if the member presents with Wellcare Medicare and Sunshine Health Medicaid, providers will continue to submit the claim to Wellcare for processing for the Medicare claim, which initiates the spawn process. You can only purchase one membership at a time. Annual wellness visits are included in your benefits, and are your opportunity to discuss your health concerns and options for care. WellCare Reviews. . By continuing to use our site, you agree to our Privacy Policy and Terms of Use. As we work to combine the best of both companies, we expect the transition period to last for approximately 18-24 months. LTC Case Managers submit authorization requests to our LTC UM Team who reviews, processes and initiates the service authorizations. Member Discounts | Wellcare Medicaid-enrolled provider types that are eligible to provide the vaccine (must have a Medicaid ID) include: physicians, extenders, pharmacies (via pharmacists), Federally Qualified Health Centers, rural health clinics and county health departments. Providers will continue to receive two (2) explanation of payments (EOPs). Childrens Medical Services Health Plan: Contact your Provider Relations representative, or Provider Services at 1-866-799-5321. If providers are not in agreement with the determination of a previously disputed claim issue, inquiries should be directed to our Operations Account Resolution (OAR) team atPSU_ProviderInquiries@wellcare.com. Providers are encouraged to submit online via Sunshine HealthsSecure Provider Portal. Non-Wellcare Providers; Medicare. Copyright 2023 Wellcare Health Plans, Inc. Looks like you already have an active Premium membership! Get a Monthly Allowance for Groceries with a Healthy Food Card Having one administrator will also streamline communications, helping us align accountability, eliminate duplications and provide a consistent message. Peanut butter, almond butter. One of the benefits of being a Wellcare member is our 24-Hour Nurse Advice Line. Private Duty Nursing, Personal Care, Home Health, Adult Companion Care, Adult Day Health Care, Assistive Care Services, Attendant Care, Companion Care, Homemaker, Intermittent and Skilled Nursing LPN & RN and Respite Care(home). In most cases, members will keep their same care manager, doctors and prescriptions. The member ID card drives the claims process and the contract under which eligible services are paid. The table below lists the number of CMS members that earned rewards during the evaluation period. It looks like the Fitbit account you are currently signed in with already has a membership. LTC Case Managers submit authorization requests to our LTC Utilization Management team to review processes and initiate the service authorizations. Earn rewards for attending an outpatient follow up appointment with a behavioral health provider within seven days after discharge from an inpatient facility. BOX 3070,Farmington, MO 63640-3823,ATTN: CLAIMS DEPARTMENT, Yes, providers can still utilize Availity to submit claims; however, if your specialty type falls under those listed above as required to submit to HHA Exchange, providers should contact the HHAX EDI team directly at. Manyof our plans have $0 premiums and Part D coverage. Medicare Advantage plans through a contract with CMS and a D-SNP plan through contracts with CMS and AHCA. Home For Providers For Brokers Drug List (Formulary) and Other Documents, Allergy medicines like Flonase and Claritin, Baby items like diapers, baby wipes and safety locks, Cold and cough medicines like Mucinex and DayQuil/Nyquil, Daily living items like reaching aid devices and bath mats, Dental items like toothpaste and denture cleaner, First aid items like bandages and rubbing alcohol, Herbals supplements like fish oil and ginseng, Medical supplies like blood pressure monitors, canes and braces, Vitamins like Centrum multi-vitamins and vitamin C, Know your exclusive member discount code (. Michelle R. July 10, 2023 @mroy99. Target timeframe is within one (1) business day of when message is received; however, this is also dependent on the complexity of the issue. The membership will be linked to your Fitbit account. Questions and Answers Local DSS Medicaid Letters (Notices) Did You Lose Your Medicaid Coverage? Centene is the parent company of Sunshine Health; WellCare is the parent company of WellCare of Florida and Staywell Health Plan. During the transition period, we will work with AHCA and DOH to integrate our operations under one plan. As we work to combine the best of both companies, we expect the transition period to last for approximately 18-24 months. There is no prescription needed. Post-Behavioral Health Admission Follow up Visit. You can place your order in a few different ways. Log In. Limitations, co-payments and restrictions may apply. Become a Broker. )9vhFI$E#"e6)|w?7}n!V H014[,E8GH=Hz&KvD6"q@. Must submit a consent form signed by members parent/guardian, verbally pledge to stop tobacco use and complete all four sessions within six months of the first session. Members enjoy special savings on medical alert systems from LifeStation. During these sessions, our Health Coaches can help answer questions about how to improve health. Register and get started today! To get started. Age 10 years old and up. Find a Provider | Wellcare Limitations and exclusions may apply. Card cannot be used everywhere Visa debit cards are accepted. Find your dedicated administrator. My Health Pays Rewards - Home State Health . Sunshine Health offers dedicatedProvider Engagement Administratorlocated in offices across Florida. Additional Benefits All orders of $25 or more receive free shipping. August 11, 2021. Beginning July 1, 2021, the Healthy Rewards program replaced the My Health Pays rewards program previously available to Allwell Medicare Advantage members across all states. Thanks for being a member! WellCare Medicare also offers a medication therapy management program designed to help you reduce your medication risks, increase your knowledge of prescription drugs, and promote healthy . Your child can earn rewards while participating in these programs. Please check that the email youve entered is correct. A medical monitoring system provides a safety net for people who might need immediate medical assistance when no oneelse is there to help. Valued providers for Sunshine Health and WellCare of Florida: Centene and WellCare/Staywell Health Plan brought our health plans together to better serve our members, providers, partners and communities on October 1, 2021. In general, though, providers are required to notify the health plan within 90 days of terminating a provider or providers from a group or contract. Complete HRA within 60 days of enrollment. Get to know us, and see how we can help you take your business to the next level. Call Provider Services at 1-844-477-8313. This tool helps WellCare of Florida members find a provider, physician, specialist, hospital or pharmacy. enter your Subscriber / Member ID as your unique promo code. The webinars cover a variety of topics such as status updates on our integration and information that providers need to know for our specialty plans. Medicare Advantage plans through its Allwell brand through a contract with the Centers for Medicare and Medicaid Services (CMS) and a D-SNP plan through contracts with CMS and AHCA. Member Login | Florida Blue The plan offers the following programs: Tobacco Cessation Health Coaching Sessions*. The Bancorp Bank; Member FDIC. Staywell LTC members began receiving new member ID cards in September 2021. Theres no limit! Childrens Medical Services (CMS) Health Plan believes that healthy behaviors can lead to better health outcomes. Wellcare uses cookies. You can also call Sunshine Health Provider Services at 1-844-477-8313.
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